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Pregnancy outcome after in utero exposure to angiotensin converting enzyme inhibitors or angiotensin receptor blockers.

机译:子宫内暴露于血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂后的妊娠结局。

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OBJECTIVE: To examine first trimester safety of angiotensin-converting-enzyme-inhibitors (ACEIs) or angiotensin-receptor-blockers (ARBs). STUDY DESIGN: Prospective observational cohort regarding pregnancy ACEI/ARBs-exposure including contacts to two Teratology Information Services in Israel (1994-2007) and Italy (1990-2008), with two comparison groups: (1) exposed to other antihypertensives (OAH) (2) after non-teratogenic exposure (NTE) in similar time frames. RESULTS: 252 ACEI/ARBs-exposed, 256 OAH-exposed and 495 NTE-exposed pregnancies were followed-up. The rate of major congenital anomalies was comparable between the groups (8/190, 4.2%, ACEI/ARB; 9/212, 4.2%, OAH; 18/471, 3.8% NTE; p = 0.954) among first trimester exposed pregnancies. The median gestational age at delivery was two weeks earlier, rate of preterm deliveries more than 2-fold higher, and median birth weight more than 200 g lower in the ACEI/ARB and OAH groups compared to the NTE group. CONCLUSION: The present study suggests that ACEI/ARBs are not major teratogens when used in the first trimester, and can reassure women with similar exposures.
机译:目的:研究血管紧张素转化酶抑制剂(ACEIs)或血管紧张素受体阻滞剂(ARBs)的孕早期安全性。研究设计:关于妊娠ACEI / ARB暴露的前瞻性观察队列,包括与以色列(1994-2007年)和意大利(1990-2008年)的两个畸形学信息服务机构的接触,以及两个比较组:(1)暴露于其他降压药(OAH) (2)在类似时间范围内进行非致畸性暴露(NTE)之后。结果:接受252次ACEI / ARB暴露,256次OAH暴露和495次NTE暴露。在孕早期暴露的妊娠中,两组之间的主要先天性异常发生率相当(8 / 190,4.2%,ACEI / ARB; 9 / 212,4.2%,OAH; 18 / 471,3.8%NTE; p = 0.954)。与NTE组相比,ACEI / ARB和OAH组的早产中位数早于两周,早产率高2倍多,出生体重中位数低200 g以上。结论:本研究表明,在头三个月使用ACEI / ARBs不是主要的致畸剂,并且可以使暴露于相似暴露水平的妇女放心。

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