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Comment & Response
November 2017

Maternal β-Blocker Use and Fetal Cardiac Anomalies—Reply

Author Affiliations
  • 1Division of Cardiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
  • 2Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
JAMA Intern Med. 2017;177(11):1692-1693. doi:10.1001/jamainternmed.2017.4900

In Reply We would like to thank Dr Keskin-Arslan and colleagues for their comments and questions. In our Research Letter,1 we did analyze the association between specific β-blockers and cardiac anomalies. We did not show those results in the original publications owing to space limitations, but we are grateful for the opportunity to share the results here. The Table summarizes the unadjusted and adjusted associations between maternal β-blocker use and congenital cardiac anomalies in the infant. In univariate analyses, exposures to atenolol or labetalol were associated with increased odds for fetal congenital cardiac anomalies, while exposure to metoprolol or propranolol did not. In multivariable analyses with adjustment for confounders, there was no longer an association between exposures to any of the β-blockers subtypes with fetal congenital cardiac anomalies, suggesting that the increased crude odds ratios were related to confounding.