Table 2. Summary of Antihypertensive Drugs Used During
Pregnancy
Category
Maternal Side
Effects
Teratogenicity or
Fetal-Neonatal
Adverse Effects
Class/Level of
Evidence
Centrally acting α2-
adrenergic agonist
(eg, methyldopa)
Sedation, elevated
LFTs, depression
No IIa-C
Diuretics (thiazide) Hypokalemia No III-B
β-Blockers (atenolol Headache Associated with fetal
growth restriction
III-B
β-Blockers (pindolol,
metoprolol)
Headache Possible fetal growth
restriction, neonatal
bradycardia
IIa-B
Calcium channel
blockers (eg,
nifedipine)
Headache; possible
interaction with
magnesium sulfate;
may interfere with
labor
No I-A
Combined α-β
blockers (labetalol)
May provoke asthma
exacerbation
Possible neonatal
bradycardia
IIa-B
Hydralazine Reflex tachycardia,
delayed hypotension
Neonatal
thrombocytopenia,
fetal bradycardia
III-B
ACE inhibitors,
angiotensin receptor
blockers, renin
inhibitors
Skeletal and
cardiovascular
abnormalities,
renal dysgenesis,
pulmonary
hypoplasia
III-C
Modified from Umans JG, Abalos EJ, Lindheimer MD. Antihypertensive treatment.
In: Lindheimer MD, Roberts JM, Cunningham FG, eds. Chesly's
Hypertensive Disorders in Pregnancy. Amsterdam: Academic Press,
Elsevier; 2009:369–338. With permission from Elsevier, Copyright © 2009.
