Increasing exposure to angiotensin-converting enzyme inhibitors in pregnancy - 21/08/11
Reprints: William O. Cooper, MD, MPH, Child and Adolescent Health Research Unit, Vanderbilt Children’s Hospital, AA-0216 MCN, Nashville, TN 37232-8555Résumé |
Objective |
The objective of the study was to identify angiotensin-converting enzyme (ACE) inhibitor prescription-filling trends in pregnant women.
Study Design |
This was a retrospective cohort study in women continuously enrolled in Tennessee Medicaid during pregnancy who delivered a live infant or had a fetal death between 1986-2003 (n = 262,179).
Results |
ACE inhibitor exposures increased more than 4-fold: from 11.2 per 10,000 pregnancies in 1986-1988 to 58.9 per 10,000 pregnancies by 2003 (adjusted risk ratio [RR], 4.49; 95% confidence interval [CI], 2.78-7.25). Exposures in the second and third trimesters nearly tripled (RR, 2.88; 95% CI, 1.45-5.75) and did not decrease following a US Food and Drug Administration black box warning against such use in 1992. Exposures were most common among women 35 years of age or older.
Conclusion |
Despite evidence of fetal complications associated with ACE inhibitor use during pregnancy, the number of pregnant women with pregnancy-related ACE inhibitor exposures increased steadily between 1986-2003. Better methods are needed to reduce fetal exposure to potentially teratogenic prescribed medications.
Le texte complet de cet article est disponible en PDF.Key words : angiotensin-converting enzyme inhibitor, pregnancy, prescription, teratogen
Plan
| This work was supported in part by the US Food and Drug Administration Contract 223-02-3003; National Institute of Diabetes, Digestive, and Kidney Diseases Training Grant DK020593; and Agency for Healthcare Research and Quality Centers for Education and Research on Therapeutics Grant HS-10384. |
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| Cite this article as: Bowen ME, Ray WA, Arbogast PG, et al. Increasing exposure to angiotensin-converting enzyme inhibitors in pregnancy. Am J Obstet Gynecol 2008;198:291.e1-291.e5. |
Vol 198 - N° 3
P. 291.e1-291.e5 - mars 2008 Retour au numéro
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