Oral Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2018

Nadolol use in pregnancy and Small for Gestational Age (SGA) newborns at term: a case series. (#5)

Thomas Basso 1 , Christoph Lehner 2 , Annabelle Lamprecht 1 , Karin Lust 1 , William Parsonage 3 , Haris Haqqani 4 , Renuka Sekar 2
  1. Department of Obstetric Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
  2. Centre of Advanced Prenatal Care, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
  3. Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
  4. Department of Cardiology, The Prince Charles Hospital, Brisbane, Queensland, Australia


Nadolol, a hydrophilic, long-acting, non-selective beta-blocker, is commonly used to treat congenital long QT-syndrome (LQTS) in non-pregnant adults. Nadolol is efficacious in both primary and secondary prevention of cardiac events in non-pregnant adults with LQTS.Recent evidences suggests Nadolol may be superior to other beta-blockers at preventing cardiac events in these patients and hence more women are continuing Nadolol during pregnancy.

The current published data regarding Nadolol in pregnancy is limited to a single case and suggests that use during pregnancy may be associated with SGA of the fetus.2 This case series will contribute to the literate on the possible effects of Nadolol on the fetus and assist with counselling women.

Case series:

This case series describes three pregnancies in two mothers treated with Nadolol for LQTS during pregnancy. In all three cases, the newborns were SGA with birth weights below the 10th percentile at term using Fenton growth charts. The mothers were non-smokers and had no other significant medical history.
Informed consent from both women was obtained prior to publication.


This case series suggests a possible association between Nadolol use in pregnancy and SGA at term.
Adding Nadolol to a cardiac registry may be helpful to further define its implications on pregnancy outcome.



  1. 1. Abu-Zeitone ABSPMSP, Peterson DRP, Polonsky BMS, McNitt SMS, Moss AJMD. Efficacy of Different Beta-Blockers in the Treatment of Long QT Syndrome. JACC. 2014;64(13):1352-8.
  2. 2. Fox RE, Marx C, Stark AR. Neonatal effects of maternal nadolol therapy. Am J Obstet Gynecol 1985;152:1045–6.