Comparison of amlodipine versus nifedipine for hypertension during
pregnancy: a systematic review and meta-analysis
Abstract
Backgroud: There is a lack of sufficient evidence regarding efficacy and
safety of amlodipine on treating hypertension during pregnancy.
Objective: To compare the efficacy and safety of amlodipine with
nifedipine on hypertension during pregnancy. Search strategy: PubMed,
Embase, Cochrane Library, clinicaltrials.gov, Chinese National Knowledge
Infrastructure, Wanfang Database and China Biology Medicine disc were
searched from inception to April l5, 2021. Selection criteria:
Randomised controlled trials were included. Data collection and
analysis: Data extraction was carried out by one researcher and checked
by another. Results were reported as risk ratios (RR) for dichotomous
outcomes or mean differences (MD) for continuous outcomes, with 95%
confidence intervals (CI). Results: Seventeen RCTs were included.
Amlodipine was found the efficacy is slightly superior to nifedipine on
treating hypertension during pregnancy (RR 1.06, 95% CI 1.01 to 1.10)
with a decreased risk for maternal side effects (RR 0.42, 95% CI 0.29
to 0.61). Subgroup analysis found amlodipine can get a better control on
SBP (RR -11.68, 95% CI -17.98 to -5.37) and DBP (RR -7.44, 95% CI
-13.81 to -1.06) compared with extended release nifedipine. In addition,
there was no difference between amlodipine and nifedipine on pregnancy
outcomes including caesarean section, premature labour, placental
abruption, FGR, fetal distress, neonatal asphyxia. Conclusions: Given
the results of this systematic review and meta-analysis, amlodipine can
be effectively and safely used for hypertension during pregnancy. Key
words: Amlodipine, Nifedipine, Hypertension during pregnancy,
Meta-analysis Tweetable abstract: This review found that amlodipine is
noninferior to nifedipine in managing hypertension during pregnancy.