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Editors Selection IGR 19-2
Medical Treatment: Low birth weight and glaucoma treatment
Comment by Sameh Mosaed on:
24800 Antiglaucoma medications during pregnancy and the risk of low birth weight: a population-based study, Ho JD; Hu CC; Lin HC, British Journal of Ophthalmology, 2009; 93: 1283-1286
A recent study by Ho et al. (1742) evaluates the incidence of low birth weight (LBW) infants born to women taking topical anti-glaucoma medications. The authors extracted data from the National Health Insurance Data Set in Taiwan, to compare 244 mothers on topical glaucoma medications to 1952 mothers matched for maternal age, gestational age, and the presence of maternal hypertension and diabetes in this population-based study. The authors found that 10.7% of women taking topical glaucoma medications delivered low birth weight infants compared to 6.2% in the control group. This represented a 1.63 times increased odds of having a low birth weight infant for mothers taking these drugs. However, when looking specifically at beta blockers, no significant difference in the risk of low birth weight infants was observed compared to the comparison cohort. Interestingly, the authors found that 28% of women taking a topical carbonic anydrase inhibitor had low birth weight infants. The authors conclude that topical beta blockers can be first line drugs when considering medical treatment of glaucoma in the pregnant woman. Although the authors found no difference in the rate of LBW infants in the beta blocker group, no analysis was performed on the infants themselves to elucidate other negative effects of the drugs such as cardiovascular changes, fetal APGAR scores, etc. In addition, there is no information as to the timing of beta blocker exposure in the gestational period. It may be that the effects impact the fetus differently depending on the trimester of gestation. As the authors point out, there was no measurement of compliance, nor analysis of other potential confounders such as smoking or nutritional status of the mother. It is difficult to conclude that these drugs may be a first line therapy without analyzing other potential detrimental effects besides low birth weight. Nevertheless, this study adds more insight in an area that is sparse in information and merits further efforts of investigation.
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