Labetatol - questions

[msck123456]

Hi everyone,
I am 21 weeks pregnant and I’ve just been put on Labetalol as my blood pressure spikes sometimes to be borderline high. Also my mum had high blood pressure and pre-eclampsia while she was pregnant with my older brother.
Ive asked doctors and also read on NHS website that Labetalol can effect baby growth and blood sugar level after being born. How was with you? Did you experience any of it ?
Did the drug affect there later health and development - school time, teenager life etc ?
I am bit worrying as I didn’t really take much medication in my life and it’s my first baby (after etopic pregnancy last year :( )
Many thanks

Caveat - only my experience !!

If I was prescribed it gain I’d ask for an alternative. Led to induction, c section under general, baby not feeding and couldn’t get blood sugar high enough so we spent ten days in nicu tube feeding which was horrible. I wasn’t told
until later at birth review that baby blood sugar was a risk.
the high bp did need monitoring but I could
have been offered a monitor and alternative meds, apparently. Worth a further conversation

I was on quite a high dose of labetalol in the the last day of pregnancy due to suddenly developing pre-eclampsia and HELLP syndrome and it did take a bit longer than normal to stabilise DS's blood sugar levels. The main effect seemed to be with establishing breastfeeding - he was a little low on energy so didn't want to feed for long enough. They monitored it with heel prick tests and the problem was quickly fixed with a few very small formula top ups to help give him energy to get feeding going. I found it was quite distressing at the time as nobody told me at the time that this could be an effect of the labetalol so I thought the topups were a sign that I was doing something wrong with the feeding and wouldn't be able to breastfeed (I also blame the day 3 emotional crash!) but he got back to normal blood sugar quickly and I went on to breast feed for 2.5 years!

DS was a little bit growth restricted (he was between 2nd and 9th percentile at birth) but that was due to the pre-eclampsia rather than the labetalol. He's absolutely fine now, no discernable long term effects and he's catching up height wise. The thing to remember is that having uncontrolled blood pressure is much more of a risk to you and the baby than the medication they give you to control it. You might want to discuss whether it might help to take low dose aspirin with your medical team as this can reduce the risk of pre-eclampsia.

Good luck!

I've had to take labetalol in two pregnancies - DD1 for high blood pressure and DD2 for preeclampsia. For DD2, i had to take labetalol and nifedipine together. You can always ask if they would be willing to consider nifedipine instead? I was offered the choice for DD2 and only had to add labetalol when the nifedipine wasn't controlling it well enough. But I was much further along that you are - 37w for DD1 and 36w for DD2, so not sure if that makes a difference.

When you've had labetalol, you have to stay for 24hrs and they take 3 sets of blood from baby to check the sugars are going in the right direction. DD1's blood sugars were affected - she had neonatal hypoglycemia, but they whisked her off and got some medication for her to stabilise her sugars. She also had an infection (sepsis, which needed a 2 week NICU stay), so that could have also affected her sugars - its hard to know if the labetalol alone was to blame. DD2's sugars started to dip a little and was spotted by the three blood sugar checks, but I gave her a little bit of formula and it topped her up until I could express some more colostrum for her. That corrected her sugars and we were discharged within 48 hours from the postnatal ward. Interestingly, I was on the labetalol for only 2days before DD1 was born and 3weeeks before DD2 was born, so its strange that DD1 was affected the most.

High blood pressure and preeclampsia also affect baby's growth. Both of mine were born quite little but soon caught up to their natural growth line (DD1 at about 1yr, DD2 just now at around 6months).

Can't comment on long term impacts as DD1 is only 3yo, but I would say that high blood pressure is very dangerous for both mum and baby so I was very happy to accept medication in both pregnancies.

Don’t worry OP. I was on huge IV doses of Labetalol and Methyldopa for over 4 weeks after being admitted to hospital (weeks 22 to 26 at which point my son was born by C section). He was in neonates for 3 months and has done fine - Oxford degree, great job, own home, getting married next year. He has good friends and is living a busy, happy life. Put your feet up and try to relax if you can. Best of luck to you and your little one.

Thank you everyone for all the responses. That’s gave me more confidence in choosing to take the medication.
Thanks a lot again

2 pregnancies on labetalol - first one is now a strong healthy confident 7yo with no issues, bright as a button, doing brilliantly at school. Second one is a squishy 3month old. Similarly doing v well, gaining weight and bouncy.
First pregnancy was a bit of a disaster but not due to labetalol - ended up on nicu at 31 weeks. No issues with blood sugar etc.
Second - blood pressure well controlled and finished with lovely elective section at 37 weeks, baby small but perfectly formed, no issues with feeding and blood sugar remained stable throughout postpartum period. Discharged 26hrs post section.
Baby was monitored for temperature and blood sugar after birth so there were a couple of extra checks but nothing too stressful. I expressed colostrum antenatally so I had some options in case he did have low sugars.
Best of luck with your pregnancy!

I had labitalol from 30-32weeks due to high bp and then they changed it to nifedipine because labitalol wasn’t really doing much. Then increased the nifedipine dose.

DS was born at 35 weeks due to preeclampsia. He did need a bit of help with his sugar levels once born, plus jaundice treatment, and needed 12 days in scbu because he was too sleepy to wake up for milk. He’s now a 1.5yr old and it’s too early to say what he will be like as a child but he’s an energetic healthy toddler.

Like a PP, I took labetalol late in pregnancy for pre-eclampsia, from 36 weeks for 1 week with DC1, and 2 weeks for DC2 before they were delivered. No problem with blood sugars for either.

DC1 is 5 and started school a few weeks ago, and is absolutely flying. Mastering phonics as quickly as she can be taught them. She was quite large at birth, but dropped to between the 10th and 25th centiles. She's grown quite a lot recently, as she's now bang on the 50th for her age.

DC2 is 2 1/2, and was also big for his gestation, but didn't drop so much as his sister. He's always been somewhere between the 50th and 75th. I can't speak for aptitude yet, but he catches on quickly, and I think he's quite smart.

They were both slow to walk at 16 and 17.5 months respectively. DC1 was also slow to talk, but had some ENT issues her Dad also had causing glue ear, so unlikely to be related to labetalol. IMO DC2 doesn't talk as clearly as others his age, but I can understand him and his vocabulary is expanding by the day.

These are really useful decisions aids! Labetalol is a first line treatment in most units and works in a different way to nifedipine so may be more (or less) effective depending on your individual circumstances

action-on-pre-eclampsia.org.uk/wp-content/uploads/2019/11/High-blood-pressure-in-pregnancy-infographic-WEB.pdf

action-on-pre-eclampsia.org.uk/wp-content/uploads/2019/11/High-blood-pressure-in-pregnancy-blood-pressure-PDA-WEB.pdf

I took labetalol in my first pregnancy, although later than you. Was induced at 38 weeks as it didn’t really work! DD1 is now 15, 5ft 10 and no signs of any ill effects (I had no idea there could be any!).

I was on labetalol for both my pregnancies. It had absolutely no negative effects. The harmful effects of high BP to myself and my babies far outweighed any risks of taking it. Both mine had good birth weights, caused no issues whatsoever.

I know this has been commented on a lot, but thought I’d give my two-cents! Congratulations by the way!

The overall problem is high blood pressure as opposed to the medication. Unfortunately, all medication can sometimes have an impact in pregnancy or be it on the baby or the mother and that’s because generally it is unethical to do control trials whilst women are pregnant.

High blood pressure, itself, is it risk to you and your baby. Having said that, there are obviously ways that your blood pressure can be managed so that it remains controlled and therefore prevents the occurrence of conditions such as pre-eclampsia. High blood pressure as you head into your third trimester, is often a reason for induction because the way to fix gestational hypertension and pre-eclampsia is by having your baby and removing the placenta.

Can sometimes impact babies ability to maintain blood sugars. Therefore, following birth your baby will have mandatory glucose testing. Providing your baby passes the 2/3 checks, there is no court for concern and you’ll have a follow-up review for your blood pressure medication and ongoing treatment with the Drs/GP as part of your postnatal care.

There are other alternatives to Labetalol and many are often used in conjunction with eachother such as Nifedipine. Labetalol is a “quick release” medication and Nifedipine tends to be much slower. In turn, you’ll be offered more scans for being under care for having hypertension that is medicated.

I hope you have a swift rest of your pregnancy and congratulations on your little one in advance :)

Do you mind if I talk to you about your experience further? I’m only 18 weeks and have just been prescribed this and am utterly panicking🥴