Rate of Postpartum Readmission for Hypertension After Prescribing Nifedipine Upon Hospital Discharge Compared With Labetalol: A Systematic Review.

Abstract

<h4>Objective</h4>To systematically review the literature to evaluate the rate of postpartum readmission for hypertension in individuals with hypertensive disorders of pregnancy discharged on nifedipine compared with those discharged on labetalol.<h4>Data sources</h4>We explored EMBASE, MEDLINE, Web of Science, CINAHL, ClinicalTrials.gov, and CENTRAL for studies that compared the rate of postpartum readmission for hypertension in individuals with hypertensive disorders of pregnancy who were treated with nifedipine, compared with labetalol.<h4>Methods of study selection</h4>Two reviewers separately identified studies, obtained data, and gauged study quality. The rate of postpartum readmission for hypertension was compared, and 95% CIs were estimated.<h4>Tabulation integration and results</h4>Three retrospective cohort studies and two randomized controlled trials were identified, with 30,950 individuals with postpartum hypertension that required treatment with nifedipine, compared with labetalol. In these studies, 39.6% (12,212/30,950) were treated with nifedipine and 60.5% (18,738/30,950) were treated with labetalol. Studies evaluated individuals with readmission for postpartum hypertension who delivered from January 2006 to December 2022. Four studies were conducted in the United States, and one was conducted in Pakistan. The weighted portion in individuals with readmission for postpartum hypertension was 2.4% (95% CI, 1.5-3.5%) in the nifedipine group, compared with 6.5% (95% CI, 4.1-9.3%) in the labetalol group. Based on these five comparative studies, postpartum readmission for hypertension occurred less in individuals treated with nifedipine than in individuals treated with labetalol.<h4>Conclusion</h4>Treatment with nifedipine in individuals with hypertensive disorders of pregnancy is associated with lower rates of postpartum readmission for hypertension, compared with labetalol.<h4>Systematic review registration</h4>PROSPERO: CRD42024526931.