Anti-hypertensive treatment for mild pregnancy hypertension in pregnancy remains controversial. Aim to synthesize the evidence on randomized controlled trials (RCTs) of anti-hypertensive treatment for mild pregnancy hypertension.
We searched various databases from the inception to June 2022, using keywords including: hypertension; pregnancy; therapy; treatment; pregnancy outcomes; maternal outcomes; perinatal outcomes. Only RTCs of anti-hypertensive treatment for mild hypertension in pregnancy comparing placebo/no therapy were included. We used Review Manager version 5.3 for statistical analyses.
8 studies were eligible with a total of 4211 participants. Compared with control, active treatment decreased preeclampsia (OR 0.55; 95%CI, 0.39-0.78), placental abruption (OR 0.39; 95%CI, 0.17-0.91), severe hypertension (OR 0.35; 95%CI, 0.17-0.71), end-organ dysfunction (OR 0.34; 95%CI, 0.19-0.62), preterm birth (OR 0.69; 95%CI, 0.59-0.82), no increased risk of small for gestational age (SGA) (OR 1.25; 95%CI, 0.78-2.00), admission to NICU (OR 0.83; 95%CI, 0.54-1.28). Subgroup analyses demonstrated that the tight control group did not show an advantage over the less-tight control group in improving pregnancy outcomes.
In pregnant women with mild pregnancy-induced hypertension or chronic hypertension, anti-hypertensive treatment still provided precise benefits of improving pregnancy outcomes without increased risk in fetal outcomes.

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