Efektivitas dan Keamanan Nifedipin dibandingkan dengan Labetalol pada Hipertensi dalam Kehamilan
Suatu Tinjauan Sistematik
DOI:
https://doi.org/10.57214/jka.v10i1.1064Keywords:
Antihypertensive Therapy, Hypertension, Labetalol, Nifedipine, PregnancyAbstract
Hypertensive disorders of pregnancy remain a leading cause of maternal and perinatal morbidity and mortality worldwide. Nifedipine and labetalol are commonly recommended as first-line antihypertensive agents during pregnancy; however, evidence regarding their comparative effectiveness and safety is still evolving. This systematic review aimed to evaluate and compare the effectiveness and safety of nifedipine versus labetalol in the management of gestational hypertension, chronic hypertension, and preeclampsia. The review was conducted according to PRISMA 2020 guidelines. A comprehensive literature search was performed in PubMed, ScienceDirect, and Google Scholar for randomized controlled trials published between 2016 and December 2025. Studies comparing nifedipine monotherapy with labetalol monotherapy and reporting systolic and/or diastolic blood pressure outcomes were included. Six RCTs involving 2,806 pregnant women met the inclusion criteria. Both drugs were effective in reducing blood pressure. Nifedipine demonstrated a faster onset of blood pressure reduction, particularly in acute hypertensive emergencies, with mean differences ranging from 12 to 17 minutes compared with labetalol. No significant differences were observed in long-term blood pressure control or neonatal outcomes. Maternal adverse effects were generally mild and comparable. Overall, both agents exhibit similar efficacy and safety profiles, with nifedipine offering advantages in rapid blood pressure control in acute settings.
References
Akre, S., Sharma, K., Chakole, S., & Wanjari, M. B. (2022). Eclampsia and its treatment modalities: A review article. Cureus, 14(10), e29080. https://doi.org/10.7759/cureus.29080
Ashworth, D., Battersby, C., Bick, D., Green, M., Hardy, P., Leighton, L., Magee, L. A., Maher, A., McManus, R. J., Moakes, C., Morris, R. K., Nelson-Piercy, C., Sparkes, J., Rivero-Arias, O., Webb, A., Wilson, H., Myers, J., & Chappell, L. C. (2023). A treatment strategy with nifedipine versus labetalol for women with pregnancy hypertension: Study protocol for a randomised controlled trial (Giant PANDA). Trials, 24(1), Article 582. https://doi.org/10.1186/s13063-023-07582-9
Donel, S., Novri, D. A., Hamidy, Y., & Savira, M. (2022). Effectiveness of nifedipine, labetalol, and hydralazine as emergency antihypertension in severe preeclampsia. F1000Research, 11, Article 125944. https://doi.org/10.12688/f1000research.125944.1
Eze, O. C., Fehintola, A. O., Adeyinka, A. D., Adepiti, C. A., Awowole, I. O., Ijarotimi, A. O., Olajide, B. E., Akinyosoye, A. D., Zainab, A.-R. F., Oluwole, A. E., & Orji, E. O. (2025). Efficacy of oral labetalol vs nifedipine in the management of severe hypertension in pregnancy: A randomized controlled trial. medRxiv. https://doi.org/10.1101/2025.05.06.25327088
Hup, R. J., Damen, J. A. A., Terstappen, J., Klein Haneveld, M. J., Terstappen, F., Magee, L. A., Lely, A. T., & Depmann, M. (2025). Oral antihypertensive treatment during pregnancy: A systematic review and network meta-analysis. American Journal of Obstetrics and Gynecology, 233(4), 250–262. https://doi.org/10.1016/j.ajog.2025.04.011
Khetan, S., & Shetty, V. H. (2024). A comparative study of nifedipine versus labetalol in hypertensive crisis during pregnancy: A randomized controlled study. International Journal of Science and Research, 13(6), 1278–1282. https://doi.org/10.21275/sr24619220425
Kumari, P., Kumari, O., Pankaj, S., & Jha, K. (2021). A randomized trial of intravenous labetalol versus oral nifedipine in acute blood pressure control in hypertensive emergencies of pregnancy. International Journal of Clinical Obstetrics and Gynaecology, 5(5), 237–242. https://doi.org/10.33545/gynae.2021.v5.i5d.1046
Li, L., Xie, W., Xu, H., & Cao, L. (2023). Oral nifedipine versus intravenous labetalol for hypertensive emergencies during pregnancy: A systematic review and meta-analysis. Journal of Maternal-Fetal and Neonatal Medicine, 36(2), 1–10. https://doi.org/10.1080/14767058.2023.2235057
Magee, L. A., & von Dadelszen, P. (2018). State-of-the-art diagnosis and treatment of hypertension in pregnancy. Mayo Clinic Proceedings, 93(11), 1664–1677. https://doi.org/10.1016/j.mayocp.2018.04.033
Palmiero, P., Caretto, P., Ciccone, M. M., & Maiello, M. (2025). Long-term cardiovascular risk and maternal history of pre-eclampsia. Journal of Clinical Medicine, 14(9), Article 3121. https://doi.org/10.3390/jcm14093121
Panda, S., Das, R., Sharma, N., Das, A., Deb, P., & Singh, K. (2021). Maternal and perinatal outcomes in hypertensive disorders of pregnancy and factors influencing it: A prospective hospital-based study in Northeast India. Cureus, 13(3), e13982. https://doi.org/10.7759/cureus.13982
Sahai, R., Nidhi, A., Ranjan, R., & Lal, S. (2020). Comparative study of oral nifedipine versus intravenous labetalol in severe hypertension in pregnancy: A randomized controlled study. Indian Journal of Obstetrics and Gynecology Research, 7(1), 75–80. https://doi.org/10.18231/j.ijogr.2020.016
Sanusi, A. A., Leach, J., Boggess, K., Dugoff, L., Sibai, B., Lawrence, K., Hughes, B. L., Bell, J., Aagaard, K., Edwards, R. K., Gibson, K. S., Haas, D. M., Plante, L., Metz, T. D., Casey, B., Esplin, S., Longo, S., Hoffman, M. K., Saade, G. R., … Tita, A. T. N. (2024). Pregnancy outcomes of nifedipine compared with labetalol for oral treatment of mild chronic hypertension. Obstetrics & Gynecology, 144(1), 126–134. https://doi.org/10.1097/AOG.0000000000005613
van de Vusse, D., Mian, P., Schoenmakers, S., Flint, R. B., Visser, W., Allegaert, K., & Versmissen, J. (2022). Pharmacokinetics of the most commonly used antihypertensive drugs throughout pregnancy methyldopa, labetalol, and nifedipine: A systematic review. European Journal of Clinical Pharmacology, 78(11), 1763–1776. https://doi.org/10.1007/s00228-022-03382-3
Wang, W., Xie, X., Yuan, T., Wang, Y., Zhao, F., Zhou, Z., & Zhang, H. (2021). Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: A population-based study. BMC Pregnancy and Childbirth, 21, Article 364. https://doi.org/10.1186/s12884-021-03809-2
Webster, L. M., Myers, J. E., Nelson-Piercy, C., Harding, K., Kennedy Cruickshank, J., Watt-Coote, I., Khalil, A., Wiesender, C., Seed, P. T., & Chappell, L. C. (2017). Labetalol versus nifedipine as antihypertensive treatment for chronic hypertension in pregnancy: A randomized controlled trial. Hypertension, 70(5), 915–922. https://doi.org/10.1161/HYPERTENSIONAHA.117.09972
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