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Comparison of amlodipine versus nifedipine for hypertension during pregnancy: a systematic review and meta-analysis
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  • Jin jin Yin,
  • zhengrong Mei,
  • shengying Shi,
  • Peili Du,
  • Shumin Qin
Jin jin Yin
The Third Affiliated Hospital of Guangzhou Medical University
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zhengrong Mei
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shengying Shi
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Shumin Qin

Corresponding Author:[email protected]

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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.