{"doi":"10.1016/j.jacadv.2025.102054","title":"Comparative Effectiveness and Safety of Labetalol Versus Nifedipine for Treatment of Chronic Hypertension During Pregnancy","abstract":"BACKGROUND: Clinical guidelines recommend treatment of chronic hypertension during pregnancy, with either labetalol or nifedipine as the first-line medication. OBJECTIVES: This study aimed to compare the effectiveness and safety of labetalol and nifedipine for the treatment of chronic hypertension during pregnancy. METHODS: We used a target trial emulation approach to compare new users of labetalol with new users of nifedipine. We analyzed data from the U.S. Merative™ MarketScan® Commercial Database of insurance claims (2007-2022) for pregnant individuals with chronic hypertension and their infants. The effectiveness outcome was a composite of severe preeclampsia/eclampsia, medically indicated preterm birth, placental abruption, or stillbirth. The safety outcome was an infant born small for gestational age. We estimated risk ratios (RRs) and risk differences (RDs) with 95% CIs, adjusting for confounding with stabilized inverse probability of treatment weights. RESULTS: We studied 6,724 pregnant individuals with chronic hypertension who initiated either labetalol (n = 5,504, 82%) or nifedipine (n = 1,220, 18%) in pregnancy. The effectiveness outcome occurred in 42% in the labetalol group and 44% in the nifedipine group, with an adjusted RR of 1.03 (95% CI: 0.96-1.11) and an adjusted RD of 1.35 per 100 births (95% CI: -1.76 to 4.45). The safety outcome of small for gestational age occurred in 13% in the labetalol group and 12% in the nifedipine group, with an adjusted RR of 0.98 (95% CI: 0.82-1.16) and an adjusted RD of -0.26 per 100 births (95% CI: -2.33 to 1.81). CONCLUSIONS: This study suggests that labetalol and nifedipine have similar effectiveness and safety in treating chronic hypertension during pregnancy.","journal":"JACC Advances","year":2025,"id":513049,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9558,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1373998,"name":"Sara Siadat","orcid":null,"position":1,"is_corresponding":false},{"id":463278,"name":"Krista F. Huybrechts","orcid":"0000-0001-5805-8430","position":2,"is_corresponding":false},{"id":680270,"name":"Elliott K. Main","orcid":"0000-0001-7562-7850","position":3,"is_corresponding":false},{"id":21776,"name":"Mark A. Hlatky","orcid":"0000-0003-4686-9441","position":4,"is_corresponding":false},{"id":390982,"name":"Sonia Hernández–Dı́az","orcid":"0000-0003-1458-7642","position":5,"is_corresponding":false},{"id":418828,"name":"Brian T. Bateman","orcid":"0000-0001-5950-8683","position":6,"is_corresponding":false},{"id":724075,"name":"Stephanie A. Leonard","orcid":"0000-0001-8213-1319","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-19T02:48:11.233009Z","pmid":"40772922","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}