Treatment for mild hypertension in pregnancy with different strategies: A systematic review and meta‐analysis.

Objectives: To synthesize the evidence from randomized controlled trials (RCTs) of antihypertensive treatment for mild pregnancy hypertension. Methods: We searched various databases from inception to June 2022, using keywords including hypertension; pregnancy; therapy; treatment; pregnancy outcomes; maternal outcomes; and perinatal outcomes. Only RCTs of antihypertensive treatment for mild hypertension in pregnancy comparing placebo/no therapy were included. We used Review Manager version 5.3 for statistical analyses. Results: In all, eight studies were eligible, with a total of 4211 participants. Compared with control, the active treatment significantly prevented preeclampsia (OR 0.55; 95%CI, 0.39–0.78), placental abruption (OR 0.39; 95%CI, 0.17–0.91), severe hypertension (OR 0.35; 95%CI, 0.17–0.71), end–organ dysfunction (OR 0.34; 95%CI, 0.19–0.62) and preterm birth (OR 0.69; 95%CI, 0.59–0.82), with no increased risk of small for gestational age (SGA) (OR 1.25; 95%CI, 0.78–2.00), or admission to the NICU (OR 0.83; 95%CI, 0.54–1.28). Subgroup analyses demonstrated that the tight control group did not show an advantage over the less‐tight control group in improving pregnancy outcomes. Conclusion: In pregnant women with mild pregnancy‐induced hypertension or chronic hypertension, antihypertensive treatment still provided precise benefits of improving pregnancy outcomes without increased risk in fetal outcomes. Synopsis: Antihypertensive treatment provided precise benefits of improving pregnancy outcomes without increased risk in fetal outcomes for pregnant women with mild hypertension. [ABSTRACT FROM AUTHOR]