Oral nifedipine may be a preferential option for treating acute severe hypertension during pregnancy: a meta-analysis

Figures & data

Figure 1. Flow diagram of retrieval and selection of study. CENTRAL, Cochrane Central Register of Controlled Trials; CNKI, China National Knowledge Infrastructure.

Table 1. Characteristics of the included studies (n = 12).

Study	Country	Sample size (LG vs NG)	Age, years	Gestational age, weeks	Detailed interventions		Recruitment time	Outcomes
					Nifedipine	Labetalol
Gainder 2018	India	15 vs 15	26.5 ± 3.1	34.9 ± 2.5	10 mg tablet per orally every 15–30 min, with a maximum of 3 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg, with a maximum total dose of 220 mg	July 2012 to November 2013	SBP after treatment, required times to achieve target BP
Pei 2015	China	111 vs 110	28.7 ± 5.9	35.2 ± 1.3	30 mg tablet, orally taken, once daily	50 mg, intravenous drip at 1-4 mg every min	August 2013 to May 2015	SBP after treatment, AEs
Raheem 2011	Malaysia	25 vs 25	32.7 ± 5.1	37.3 ± 5.2	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg.	January 2010 to October 2010	Required times to achieve target BP, the number of doses, AEs
Shekhar 2013	India	30 vs 30	25.9 ± 3.9	36.1 ± 5.1	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg.	October 2012 to April 2013	Required times to achieve target BP, the number of doses, AEs
Vermillion 1999	USA	25 vs 25	27.1 ± 6.9	33.9 ± 4.7	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg.	February 1996 to February 1998	Required times to achieve target BP, the number of doses, AEs
Zulfeen 2019	India	60 vs 60	22.5 ± 3.6	33.1 ± 3.2	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg.	December 2014 to December 2016	Required times to achieve target BP, the number of doses, AEs
Lakshmi 2012	India	50 vs 50	24.0 ± 3.6	35.3	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg, with a maximum total dose of 220 mg	September 2008 and April 2010	The number of doses, AEs
Dhali 2012	India	50 vs 50	24.0 ± 2.7	n.r.	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg.	n.r.	Required times to achieve target BP, the number of doses
Dhananjaya 2015	India	30 vs 30	23.8 ± 3.8	35.8 ± 2.7	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg.	n.r.	Required times to achieve target BP, the number of doses, and AEs
Mukherjee 2016	India	30 vs 30	25.7 ± 4.2	n.r.	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg, with a maximum total dose of 220 mg	March 2015 and August 2015	Required times to achieve target BP, the number of doses
Shi 2016	China	73 vs 74	28.7	37.4	10 mg tablet, orally, with a maximum of 5 doses	Intravenous injection in an escalating dose of 20, 40, 80, 80, and 80 mg.	n.r.	Required times to achieve target BP, the number of doses, and AEs
Fu 2016	China	45 vs 45	28.4 ± 5.7	34.2 ± 1.5	5 mg tablet, 20 mg/time, orally, twice daily, with a maximum of 3 doses	Intravenous drip in a dose of 100 mg, 3times/day with a maximum total dose of 600 mg/d.	February 2013 and December 2014	SBP after treatment, AEs

LG, Labetalol group; NG, Nifedipine group; n.r., not reported; BP, blood pressure; SBP, systolic blood pressure; AEs, adverse events.

Figure 2. Risk of bias summary. Low risk of bias (green hexagons), unclear risk of bias (white hexagons), and high risk of bias (red hexagons).

Figure 3. Meta-analysis of required time to achieve target blood pressure (RTATBP) after treatment by using oral nifedipine versus intravenous labetalol.

Figure 4. Meta-analysis of the number of doses between oral nifedipine and intravenous labetalol groups.

Data availability statement

No datasets were generated for this study