RISK CLASSIFICATION ASSOCIATED WITH THE USE OF ANTIHYPERTENSIVE DRUGS DURING PREGNANCY: ANALYSIS AND CATEGORIZATION FOR MATERNAL-FETAL SAFETY

Abstract

Hypertension during pregnancy is one of the leading causes of both maternal and fetal complications and mortality. This condition develops with elevated blood pressure after the 20th week of pregnancy, usually returning to normal levels after childbirth. This study aims to analyze and classify the safety and risk-benefit profile of antihypertensive drugs used in the treatment of hypertension in pregnant women. This is a documentary, descriptive, and qualitative analysis study conducted using the Drugs platform, focusing on the use of antihypertensive medications during pregnancy and their maternal-fetal risk classification.The methodology consisted of a structured search and systematization of pharmacological and gestational safety information regarding the main antihypertensive drugs. The results demonstrated significant variation in the risk profile among pharmacological classes, highlighting the high contraindication of medications acting on the renin-angiotensin-aldosterone system (ACE inhibitors, ARBs, and renin inhibitors), as well as significant risks associated with diuretics and non-selective beta-blockers. In contrast, drugs such as methyldopa, nifedipine, and labetalol showed a better safety profile and greater clinical recommendation. It was observed that many antihypertensive drugs, although effective outside pregnancy, may compromise uteroplacental perfusion and fetal development, especially those with intense hormonal or hemodynamic effects. Therefore, the need for careful risk-benefit assessment and safe therapeutic substitution during pregnancy is reinforced. It is concluded that the management of hypertension during pregnancy should prioritize medications with greater evidence of maternal-fetal safety, making the rational use of antihypertensives and rigorous clinical monitoring essential to prevent fetal and neonatal complications.