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Poster Session 3

Category: Hypertension

Poster Session 3

(765) Oral Antihypertensives for Pregnancy Prolongation in Preterm Preeclampsia: A Systematic Review and Meta-Analysis

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

David J. Rivera, MD (he/him/his)

Resident Physician
Orlando Health Bayfront Hospital
St Petersburg, Florida, United States

Coauthor(s)

IK

Insaf Kouba, MD

Johns Hopkins All Childrens
St. Petersburg, Florida, United States
AC

Ariane Chabanne, MD

Orlando Health Bayfront Hospital
St. Petersburg, Florida, United States
KH

Krista Howard, PhD

Associate Professor of Psychology
Texas State University
San Marcos, Texas, United States
HA

Heisy B. Asusta, MD, MPH

Orlando Health
St Petersburg, Florida, United States

Objective:
This study evaluated existing data on oral antihypertensives for prolonging pregnancies complicated by severe hypertension in preterm preeclampsia.

Study Design:
An electronic literature search in the PubMed/ MEDLINE, Google Scholar, EMBASE databases and CENTRAL (the Cochrane Library) was performed. Observational and randomized controlled studies reporting pregnancy prolongation outcomes among women with preeclampsia who were treated with oral antihypertensive medications were included. Of the 62 records screened,19 were eligible for meta-analysis using the PRISMA guidelines. The following secondary complication measures of interest were quantitatively synthesized: HELLP, eclampsia, placental abruption, and neonatal respiratory distress. Statistical meta-analyses were performed using R 4.5.1 meta package. PROSPERO Registration: CRD420251090292.

Results:
Two separate models were created for studies reporting mean days (n=14; total N = 1119) and those reporting median days (n=5; total N = 424). Random-effects models were applied due to substantial heterogeneity (I2= 97.0% and 96.3%, respectively). For the studies that reported means, the pooled estimate for prolongation of pregnancy was approximately 9.79 days (95% CI: 7.15, 12.42). For studies that reported medians, the pooled prolongation was estimated at 10.62 days (95% CI: 4.05, 17.20). Findings across both models were consistent. Meta-analyses showed that the secondary complications were generally rare, but significant differences between the studies caused some variations in the results.

Conclusion:
Oral antihypertensive medications are associated with an approximate 10-day prolongation of pregnancy in preterm preeclampsia, with a low incidence of maternal and neonatal complications. These findings reinforce prior evidence and underscore the value of oral antihypertensives as a key component of expectant management, warranting further study to optimize pregnancy outcomes.