It didn't take long

Some week old news from Reuters that I never got around to.

NEW YORK (Reuters Health) - When pregnant women take ACE inhibitor medication during their first trimester, the risk of the infants having major malformations is more than doubled, according to a study in this week's New England Journal of Medicine.

Angiotensin-converting-enzyme (or ACE) inhibitors are widely used to treat high blood pressure, and are often prescribed for people with diabetes. Many formulations are available, sold under numerous brand names.

"Exposure to ACE inhibitors during the first trimester cannot be considered safe and should be avoided," Dr. William O. Cooper, from Vanderbilt University School of Medicine in Nashville, and colleagues caution.

It has already been recognized that taking ACE inhibitors during the second and third trimesters can lead to birth defects, the investigators note. It was believed that use of the drugs during the first three months of pregnancy was safe, and this idea was reinforced by studies in animals, the authors note.

However, Cooper's group was not convinced. To look into the issue, they used data from Tennessee Medicaid records to identify 29,507 infants born between 1985 and 2000, excluding infants born to mothers with diabetes. In the first trimester, 209 infants were exposed to ACE inhibitors and 202 were exposed to other blood pressure drugs.

Information regarding major malformations was obtained from linked records and hospitalization claims during the first year of life.

All told, malformations were diagnosed in 856 infants (2.9 percent). Eighteen were in the ACE inhibitor group, four in the other antihypertensive medication group, and 834 among the remaining infants.

After adjusting for demographics, year of birth, neighborhood income, and presence of chronic illnesses, Cooper and his associates estimated that the risk of major congenital malformations was 2.71-times higher in the ACE inhibitor group than the group that had no exposure to blood pressure medications.

In contrast, there was no sign of increased risk among infants exposed to other types of blood pressure medication.

"Clearly more research on the (malformation) potential of ACE inhibitors in early pregnancy is needed," Dr. J. M Friedman says in a related editorial. This study "is not the last word on the subject, but it is shocking to realize that it is almost the first."

Very interesting but I agree on more research before definitive conclusions are made. An unborn baby is very susceptible to meds the mother may use, prescribed and otherwise. I mean alcohol and tobacco. Medicine will never make pregnancy or childbirth 100% safe. Nothing is. Doctors and patients have to stay informed and weigh the risks involved with any treatment.

Dear wife was prescribed BP meds when pregnant with Daniel. I forget what ones they were. My son's problems weren't due to his mother's medications.

I saw a commercial at lunch time today. A law firm is already out looking for mothers who took ace inhibitors when pregnant and had children with health problems/birthdefects. Sheesh The ambulance chasers are already taking off on this.

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