Comparison of Therapeutic Effect of Labetalol with Nifedipine in Control of Hypertensive Disorders of Pregnancy

Background: Pregnancy-induced hypertension (PIH) is a major contributor to maternal and perinatal morbidity and mortality worldwide. Labetalol and nifedipine are commonly recommended first-line antihypertensive agents in pregnancy; however, evidence comparing their relative efficacy and fetomaternal outcomes remains variable.

Objectives: To compare the efficacy and safety of oral labetalol and oral nifedipine in the management of pregnancy-induced hypertension, with emphasis on blood pressure control, dose requirement, maternal outcomes, and neonatal outcomes.

Methods: A randomized prospective comparative study was conducted in a tertiary care hospital over one year. One hundred pregnant women diagnosed with PIH after 20 weeks of gestation were randomized into two groups: Group A received oral labetalol (n=50) and Group B received oral nifedipine (n=50). Blood pressure parameters, time to achieve target blood pressure (≤150/100 mmHg), number of doses required, need for additional antihypertensive therapy, maternal complications, and neonatal outcomes were recorded and analyzed using SPSS version 22.

Results: Baseline demographic and clinical characteristics were comparable between groups. Labetalol achieved significantly lower systolic blood pressure and mean arterial pressure at 30 minutes compared to nifedipine (p<0.05). The mean time to reach target blood pressure was significantly shorter with labetalol (28.2 ± 8.1 minutes vs. 33.4 ± 12.3 minutes; p<0.001). Fewer doses were required in the labetalol group (p=0.028). Mean blood loss during delivery and incidence of postpartum hemorrhage were significantly lower with labetalol. Neonatal birth weight was significantly higher in the labetalol group (p=0.002), while other neonatal outcomes were comparable.

Conclusion: Both labetalol and nifedipine are effective and safe for managing PIH. However, labetalol demonstrated superior efficacy with faster blood pressure control, fewer dose requirements, reduced intrapartum blood loss, and improved neonatal birth weight, supporting its role as a preferred first-line agent in PIH management.