Effects of beta 1-adrenoceptor blockade in the treatment of hypertension during pregnancy in diabetic women.

The effects of beta 1-blockade were investigated in 18 hypertensive pregnant diabetic women. The same women served as controls, covering a period just before therapy. The blood pressure was reduced in 14 women (p less than 0.01). The change in blood glucose homeostasis was statistically not different from the control period. Insulin doses were not affected. The fetal heart rate was affected by therapy, causing a decrease in baseline rate (p less than 0.05) and in acceleration amplitude (p less than 0.05). Although the incidence of suspect fetal distress, intrauterine growth retardation and preterm delivery was high, all surviving infants had normal Apgar scores at 5 and 10 min. Perinatal mortality consisted of one stillbirth. Except for respiratory problems, the incidence of neonatal complications was low. All survivors were healthy at follow-up. We found beta 1-blockade to be effective and safe in this group of high-risk pregnancies, and suggest it as an alternative for anti-hypertensive therapy in diabetic pregnancy.