Wednesday, June 7, 2006

First-Trimester Exposure to ACE Inhibitors Associated with Major Congenital Malformations


From the New England Journal of Medicine -- Major Congenital Malformations after First-Trimester Exposure to ACE Inhibitors:
Background Use of angiotensin-converting–enzyme (ACE) inhibitors during the second and third trimesters of pregnancy is contraindicated because of their association with an increased risk of fetopathy. In contrast, first-trimester use of ACE inhibitors has not been linked to adverse fetal outcomes. We conducted a study to assess the association between exposure to ACE inhibitors during the first trimester of pregnancy only and the risk of congenital malformations...

Results Infants with only first-trimester exposure to ACE inhibitors had an increased risk of major congenital malformations (risk ratio, 2.71; 95 percent confidence interval, 1.72 to 4.27) as compared with infants who had no exposure to antihypertensive medications. In contrast, fetal exposure to other antihypertensive medications during only the first trimester did not confer an increased risk (risk ratio, 0.66; 95 percent confidence interval, 0.25 to 1.75). Infants exposed to ACE inhibitors were at increased risk for malformations of the cardiovascular system (risk ratio, 3.72; 95 percent confidence interval, 1.89 to 7.30) and the central nervous system (risk ratio, 4.39; 95 percent confidence interval, 1.37 to 14.02).

Conclusions Exposure to ACE inhibitors during the first trimester cannot be considered safe and should be avoided.
Related Links: Patient Information on High Blood Pressure

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2 comments:

Jenny said...

This is so cool--I'm so excited to find this blog. Thanks for taking the time to create this! I look forward to returning often.

Maria said...

I apologize in advance if the following sounds creepy:

When I saw this piece in NEJM and Yahoo! news, I immediately thought of your weblog. I pictured a distressed kidney and a doubly-distressed fetus.

Your influence reaches the Left Coast!