{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:13:49Z","timestamp":1791807229179,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Beta\u2010blockers are prescribed for many pregnant women with heart disease, but whether there is a dose\u2010dependent effect on fetal growth remains to be examined. We aimed to investigate if antenatal beta\u2010blocker use and dose were associated with delivering a small\u2010for\u2010gestational\u2010age infant among women with heart disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>Our cohort included women with heart disease who delivered at Oslo University Hospital between 2006 and 2015. Maternal heart disease was classified into modified WHO risk scores. Women with beta\u2010blocker treatment were dichotomized into whether they had been treated with a low or high dose based on clinical factors. We compared the risk of delivering a small\u2010for\u2010gestational\u2010age infant in women exposed to high doses, low doses, or with no exposure to antenatal beta\u2010blockers while adjusting for severity of maternal heart disease in logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of a total of 540 pregnancies among women with heart disease, 163 (30.2%) were exposed to beta\u2010blocker treatment. The majority were treated with metoprolol (86.5%). Almost twice as many babies in the beta\u2010blocker group were small\u2010for\u2010gestational\u2010age, compared with the non\u2010exposed group (19.8 vs 9.5%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Women using a high\u2010dose beta\u2010blocker had a five\u2010fold increased risk of delivering a small\u2010for\u2010gestational\u2010age infant compared with non\u2010exposure (adjusted odds ratio [aOR] 4.89, 95% confidence interval [CI] 2.22\u201310.78,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Women using a low dose of beta\u2010blocker had a two\u2010fold increased risk of delivering a small\u2010for\u2010gestational\u2010age infant; however, the confidence interval included the null (aOR 1.75, 95% CI 0.83\u20133.72,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.143). Results when restricting the analyses to metoprolol showed the same pattern, but with attenuation of risks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found a five\u2010fold increased risk of delivering a small\u2010for\u2010gestational\u2010age infant in women with heart disease treated with a high dose of beta\u2010blocker, and a two\u2010fold increased risk among those treated with a low dose, showing an apparent dose\u2013response relation. Close monitoring of fetal growth is warranted among women with heart disease treated with beta\u2010blockers. As drug therapy in pregnancy concerns both mother and fetus, an optimum balance for both should be the goal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14363","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T09:20:38Z","timestamp":1650878438000},"page":"794-802","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Maternal beta\u2010blocker dose and risk of small\u2010for gestational\u2010age in women with heart disease"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8998-4285","authenticated-orcid":false,"given":"Ingvil Krarup","family":"S\u00f8rbye","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randi","family":"Haualand","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henriette","family":"Wiull","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1321-0387","authenticated-orcid":false,"given":"Anne\u2010Sofie","family":"Letting","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldrid","family":"Langes\u00e6ter","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette\u2010Elise","family":"Estensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Oslo University Hospital  Oslo 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