In a meta-analysis of randomized trials comparing different antihypertensive agents in pregnancy, the use of beta-blockers resulted in fewer episodes of severe hypertension than the use of methyldopa.13 Labetalol, a combined alpha- and beta-receptor blocker, is often recommended as another first-line18 or second-line17 therapy for hypertension in pregnancy. Although some data have suggested an association between atenolol and fetal growth restriction, 20 this finding has not been reported with the use of other beta-blockers or labetalol, and whether the observed association was attributable to the use of atenolol or to the underlying hypertension is uncertain. Nonetheless, some experts consider it prudent to avoid the use of atenolol during pregnancy.18