Exposure to angiotensin-converting enzyme inhibitors during first trimester, Is it safe to fetus?

Yip, Shing‐Kai; Leung, T.; Fung, HedyY. M.

doi:10.1080/j.1600-0412.1998.770517.x

Cited by 8 publications

(5 citation statements)

References 8 publications

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“…In particular, use of angiotensin-converting enzyme (ACE) inhibitors in the third trimester of pregnancy has been associated with ACE inhibitor-induced fetopathy, characterized by fetal hypotension, anuria-oligohydramnios, growth restriction, pulmonary hypoplasia, renal tubular dysplasia, and hypocalvaria. [1][2][3][4][5][6][7][8][9] Calcium channel blocker (CCB) use during gestation has been associated with limb defects in animal studies. 10 There are limited data addressing the effects of other antihypertensive drug exposure during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…Case reports have suggested that the use of ACE inhibitors in the first trimester does not necessarily cause anomalies, and exposure in the first trimester should not necessitate termination of the pregnancy. 4,6,7 These recommendations are based on very small numbers of patient experiences. One study reported that exposure to ACE inhibitors in the first trimester of pregnancy was associated with a 2.7-fold increased risk of a major malformation occurring compared with no exposure to ACE inhibitors.…”

Section: Introductionmentioning

confidence: 99%

“…Although antihypertensive medications are rarely necessary among women of childbearing age, their use has been associated with adverse events in pregnancy. In particular, use of angiotensin‐converting enzyme (ACE) inhibitors in the third trimester of pregnancy has been associated with ACE inhibitor–induced fetopathy, characterized by fetal hypotension, anuria‐oligohydramnios, growth restriction, pulmonary hypoplasia, renal tubular dysplasia, and hypocalvaria . Calcium channel blocker (CCB) use during gestation has been associated with limb defects in animal studies .…”

Section: Introductionmentioning

confidence: 99%

“…Because the effects of ACE inhibitors on the fetus are well documented, their exposure in women of childbearing age is limited, but some use does occur. Case reports have suggested that the use of ACE inhibitors in the first trimester does not necessarily cause anomalies, and exposure in the first trimester should not necessitate termination of the pregnancy . These recommendations are based on very small numbers of patient experiences.…”

Section: Introductionmentioning

confidence: 99%

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Antihypertensive Drugs and the Risk of Congenital Anomalies

et al. 2013

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ACE inhibitors prescribed in the first trimester of pregnancy appeared to increase the risk of congenital anomalies among the offspring of exposed women (RR 2.5, 95% CI 0.5-13.5). These drugs should be avoided in women planning to become pregnant. A marginally increased risk was also found with exposure to β-blockers (RR 1.4, 95% CI 0.6-3.3). These findings are based on small numbers and are not statistically significant.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antihypertensive Drugs and the Risk of Congenital Anomalies

et al. 2013

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“…They are often used in women of reproductive age. The use of ACE inhibitors in the first trimester only, does not appear to be related to an elevated risk of major congenital malformation above the average risk in hypertensive pregnant women (untreated or treated with other drugs) (DiavCitrin et al 2011;Moretti et al 2012;Walfisch et al 2011;Li et al 2011;KreftJais et al 1988; From the Centers for Disease Control and Prevention 1997; Lip et al 1997;Steffensen et al 1998;Yip et al 1998).…”

Section: Angiotensin-converting Enzyme Inhibitors (Aceis)mentioning

confidence: 97%

Medication Use in Pregnancy; Treating the Mother: Protecting the Unborn

Gadot

Koren

2014

Medicines for Women

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Is there an embryopathy associated with first‐trimester exposure to angiotensin‐converting enzyme inhibitors and angiotensin receptor antagonists? A critical review of the evidence

Polifka

2012

Birth Defects Research

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Drugs that interfere with the renin-angiotensin system, such as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), are widely used to manage hypertension and heart failure. Adequate functioning of the RAS is essential for normal fetal kidney development. The potential for ACEIs and ARBs to impair fetal and neonatal renal function if taken after the first trimester of pregnancy has been well documented. Although these drugs were not found to be teratogenic in animals, until recently little was known about the teratogenic effects of ACEIs and ARBs in humans when exposure was limited to the first trimester of pregnancy. New evidence from epidemiologic studies indicates that there may be an elevated teratogenic risk when these drugs are taken during the first trimester of pregnancy. However, this elevated risk does not appear to be specific to ACEIs and ARBs, but is instead related to maternal factors and diseases that typically coexist with hypertension in pregnancy, such as diabetes, advanced maternal age, and obesity. Women who become pregnant while being treated with an ACEI or ARB should be advised to avoid exposure to these drugs during the second and third trimesters of pregnancy by switching to a different class of antihypertensive drugs between weeks 8 and 10 after conception.

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Exposure to angiotensin-converting enzyme inhibitors during first trimester, Is it safe to fetus?

Cited by 8 publications

References 8 publications

Antihypertensive Drugs and the Risk of Congenital Anomalies

Antihypertensive Drugs and the Risk of Congenital Anomalies

Medication Use in Pregnancy; Treating the Mother: Protecting the Unborn

Is there an embryopathy associated with first‐trimester exposure to angiotensin‐converting enzyme inhibitors and angiotensin receptor antagonists? A critical review of the evidence

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