ACE Inihibitors for Blood Pressure and Birth Defects
June 8, 2006 by Lei
Filed under Diseases & Conditions
Blood pressure control is critically important for pregnant women and is a significant risk factor for preeclampsia. Up to now, angiotensin-converting enzyme (ACE) inhibitors have not been prescribed for women past their first trimester because they’re known to cause birth defects. A study of 29, 507 infants suggests that ACE inhibitors, such as captopril and lisinopril, may also cause birth defects in the first trimester as well. Birth defects resulting from ACE inhibitor use in later pregnancy include:
- Bone abnormalities in the skull
- Inhibition of growth
- Fatal kidney damage
Of 209 infants who were exposed to ACE inhibitors in the first trimester, 18 had birth defects with 9 of these children having heart defects. This translates to 2.7 times greater risk of birth defects in children born of mothers who had taken ACE inhibitors in the first trimester.
What’s the alternative for women who need to take medication for blood pressure control? There’s no clear answer. Most drugs are not tested in pregnant women using the gold standard randomized clinical trial format for ethical reasons. What little observational data available from studying women who unintentionally expose themselves to various drugs during pregnancy leave some room for doubt.
More interestingly, because women are having children later, they are more prone to chronic diseases like cardiovascular disease and are more likely to be on daily medication. Dr. Jan M. Friedman of the University of British Columbia recommends that “women who have taken ACE inhibitors during the first trimester should have fetal ultrasound scans and echocardiograms at about 18 weeks.”
The New York Times, June 8, 2006
