Supplemental Digital Content is available in the text. Hypertensive disorders during pregnancy are an important risk to mother and fetus, frequently necessitating antihypertensive treatment. Data describing the safety of in utero exposure to antihypertensive treatment is conflicting, with many studies suffering from significant methodological issues, such as inappropriate study design, small sample sizes, and no untreated control group. We conducted a retrospective cohort study using linked routinely collected healthcare records for 268 711 children born 2010–2014 in Scotland to assess outcomes following in utero exposure to antihypertensive medication. We identified a cohort of 265 488 eligible children born over the study period; of which, 2350 were exposed to in utero antihypertensive medication, 4391 exposed to treated late-onset hypertension, and 7971 exposed to untreated hypertension during pregnancy. Untreated hypertension was associated with increased risk of preterm birth (adjusted risk ratio [aRR], 1.15 [99% CI, 1.01–1.30]), low birth weight (aRR, 2.01 [99% CI, 1.72–2.36]) and being small for gestational age (aRR, 1.50 [99% CI, 1.35–1.66]), while in utero antihypertensive exposure was also associated with preterm birth (aRR, 3.12 [99% CI, 2.68–3.64]), low birth weight (aRR, 2.23 [99% CI, 1.79–2.78]), and being small for gestational age (aRR, 2.13 [99% CI, 1.81–2.52]). Late-onset hypertension was also associated with preterm birth (aRR, 2.21 [99% CI, 1.86–2.62]), low birth weight (aRR, 2.06 [99% CI, 1.74–2.43]), and being small for gestational age (aRR, 1.90 [99% CI, 1.68–2.16]). Our results suggest that hypertension is a key risk factor for low birth weight and preterm birth. Although preterm birth may be associated with antihypertensive medication exposure during pregnancy, these associations may reflect increasing hypertension severity necessitating treatment.

中文翻译：

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子宫内抗高血压药物暴露和新生儿结局

补充数字内容在文本中可用。怀孕期间的高血压疾病是母亲和胎儿的重要风险，经常需要抗高血压治疗。描述子宫内暴露于抗高血压治疗的安全性的数据是相互矛盾的，许多研究存在重大的方法学问题，例如研究设计不当、样本量小和没有未经治疗的对照组。我们对 2010-2014 年出生于苏格兰的 268 711 名儿童进行了一项回顾性队列研究，该研究使用相关联的常规收集的医疗记录来评估子宫内暴露于抗高血压药物后的结果。我们确定了研究期间出生的 265 488 名符合条件的儿童；其中，2350人暴露于宫内降压药，4391人暴露于治疗后的迟发性高血压，和 7971 在怀孕期间暴露于未经治疗的高血压。未经治疗的高血压与早产风险增加有关（调整风险比 [aRR]，1.15 [99% CI，1.01-1.30]），低出生体重（aRR，2.01 [99% CI，1.72-2.36]）和小胎龄 (aRR, 1.50 [99% CI, 1.35–1.66])，而宫内降压药物暴露也与早产 (aRR, 3.12 [99% CI, 2.68–3.64])、低出生体重 (aRR, 2.23 [99% CI, 1.79–2.78])，并且小于胎龄 (aRR, 2.13 [99% CI, 1.81–2.52])。迟发性高血压也与早产 (aRR, 2.21 [99% CI, 1.86–2.62])、低出生体重 (aRR, 2.06 [99% CI, 1.74–2.43]) 和小于胎龄有关 ( aRR，1.90 [99% CI，1.68–2.16]）。我们的研究结果表明，高血压是低出生体重和早产的关键危险因素。