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Am J Perinatol 2024; 41(S 01): e1996-e2003
DOI: 10.1055/a-2096-2338
Original Article

Effect of Calcium Channel Blocker on Labor Curve in Pregnant Individuals with Chronic Hypertension

Carole Barake
1   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Elizabeth Seagraves
2   Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia
,
Jim C. Huang
3   Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan
,
Dana Baraki
4   Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio
,
Thomas Donaldson
5   Department of Obstetrics and Gynecology, Temple University Hospital, Philadelphia, Pennsylvania
,
Alfred Abuhamad
2   Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia
,
Tetsuya Kawakita
2   Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia
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Abstract

Objective This study aimed to compare the labor progress between individuals who received calcium channel blocker (CCB) and those who did not receive CCB during labor.

Study Design This was a secondary analysis of a retrospective cohort study of individuals with chronic hypertension who underwent vaginal delivery at a tertiary care center from January 2010 to December 2020. We excluded individuals with prior uterine surgeries and a 5-minute Apgar score of less than 5. We used a repeated-measures regression with a third-order polynomial function to compare the average labor curves according to antihypertensive medication. Estimates of the median (5th–95th percentile) traverse times between two dilations were computed using interval-censored regression.

Results Of 285 individuals with chronic hypertension, 88 (30.9%) received CCB. Individuals who received CCB during labor compared with those who did not were more likely to deliver at earlier gestational age and to have pregestational diabetes and superimposed preeclampsia (p  < 0.01). The progress of labor in the latent phase was not found to be significantly different between both groups (median: 11.51 vs. 8.74 hours; p = 0.08). However, after stratification by parity, nulliparous individuals who received CCB during labor were more likely to have a longer latent phase of labor (median: 14.4 vs. 8.5 hours; p  = 0.03)

Conclusion A calcium channel blocker may slow the latent phase of labor in individuals with chronic hypertension. Aiming to minimize intrapartum iatrogenic interventions, allowing adequate time for pregnant individuals during the latent phase of labor is especially important if individuals are on a calcium channel blocker.

Key Points

  • Calcium channel blockers seem to be associated with a longer latent phase of labor.

  • The effect of calcium channel blocker on labor was not observed in multiparous individuals.

  • Allowing adequate labor time for individuals taking calcium channel blocker is important.

Keywords

active phase - calcium channel blocker - chronic hypertension - labor curve - latent phase

Note

This research was presented in part as a poster at the Society for Maternal-Fetal Medicine 42nd Annual Pregnancy Meeting (January 31–February 5, 2022)




Publication History

Received: 29 January 2023

Accepted: 18 May 2023

Accepted Manuscript online:
19 May 2023

Article published online:
19 June 2023

© 2023. Thieme. All rights reserved.

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