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Teratogenicity of angiotensin converting enzyme inhibitors or receptor blockers.
J Obstet Gynaecol 2011; 31(6):465-72JO

Abstract

Studies of 1st trimester exposure to ACE inhibitors and angiotensin receptor blockers examining teratogenicity have shown conflicting results. We systematically reviewed the literature and performed a meta-analysis evaluating the risk of major malformations. For the meta-analysis, we included studies comparing 1st trimester exposure to no exposure, or to exposure to other antihypertensives. Additionally, we conducted a qualitative analysis of studies that did not meet the inclusion criteria for the meta-analysis. A significant risk ratio was found when the exposed group was compared with healthy controls but not when compared with other antihypertensives. The qualitative analysis did not demonstrate a specific pattern of major malformations. Our results suggest that 1st trimester exposure to ACE inhibitors and angiotensin receptor blockers is not associated with an elevated risk of major malformations compared with other antihypertensives. A 1st trimester exposure to antihypertensives in general may be associated with an elevated risk of major malformations.

Authors+Show Affiliations

The Motherisk Program, Department of Pediatrics, Hospital for Sick Children, and Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

21823839

Citation

Walfisch, A, et al. "Teratogenicity of Angiotensin Converting Enzyme Inhibitors or Receptor Blockers." Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology, vol. 31, no. 6, 2011, pp. 465-72.
Walfisch A, Al-maawali A, Moretti ME, et al. Teratogenicity of angiotensin converting enzyme inhibitors or receptor blockers. J Obstet Gynaecol. 2011;31(6):465-72.
Walfisch, A., Al-maawali, A., Moretti, M. E., Nickel, C., & Koren, G. (2011). Teratogenicity of angiotensin converting enzyme inhibitors or receptor blockers. Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology, 31(6), pp. 465-72. doi:10.3109/01443615.2011.579197.
Walfisch A, et al. Teratogenicity of Angiotensin Converting Enzyme Inhibitors or Receptor Blockers. J Obstet Gynaecol. 2011;31(6):465-72. PubMed PMID: 21823839.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Teratogenicity of angiotensin converting enzyme inhibitors or receptor blockers. AU - Walfisch,A, AU - Al-maawali,A, AU - Moretti,M E, AU - Nickel,C, AU - Koren,G, PY - 2011/8/10/entrez PY - 2011/8/10/pubmed PY - 2012/1/20/medline SP - 465 EP - 72 JF - Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology JO - J Obstet Gynaecol VL - 31 IS - 6 N2 - Studies of 1st trimester exposure to ACE inhibitors and angiotensin receptor blockers examining teratogenicity have shown conflicting results. We systematically reviewed the literature and performed a meta-analysis evaluating the risk of major malformations. For the meta-analysis, we included studies comparing 1st trimester exposure to no exposure, or to exposure to other antihypertensives. Additionally, we conducted a qualitative analysis of studies that did not meet the inclusion criteria for the meta-analysis. A significant risk ratio was found when the exposed group was compared with healthy controls but not when compared with other antihypertensives. The qualitative analysis did not demonstrate a specific pattern of major malformations. Our results suggest that 1st trimester exposure to ACE inhibitors and angiotensin receptor blockers is not associated with an elevated risk of major malformations compared with other antihypertensives. A 1st trimester exposure to antihypertensives in general may be associated with an elevated risk of major malformations. SN - 1364-6893 UR - https://www.unboundmedicine.com/medline/citation/21823839/Teratogenicity_of_angiotensin_converting_enzyme_inhibitors_or_receptor_blockers_ L2 - http://www.tandfonline.com/doi/full/10.3109/01443615.2011.579197 DB - PRIME DP - Unbound Medicine ER -