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Antihypertensive Drugs and the Risk of Congenital Anomalies
Author(s) -
VasilakisScaramozza Catherine,
Aschengrau Ann,
Cabral Howard J.,
Jick Susan S.
Publication year - 2013
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1212
Subject(s) - medicine , relative risk , offspring , pregnancy , confidence interval , obstetrics , cohort study , biology , genetics
Study Objective To estimate the prevalence of congenital anomalies among the offspring of women exposed and unexposed to antihypertensive drugs during early pregnancy. Design Matched cohort study. Database The United Kingdom's General Practice Research Database. Subjects Women exposed to antihypertensive drugs during early pregnancy and a sample of matched unexposed pregnant women. Measurements and Main Results The prevalence of any anomaly among unexposed and exposed women was 23.5 (95% confidence interval [ CI] 14.4–38.3) and 20.9 (95% CI 10.0–43.8) per 1000 pregnancies, respectively (relative risk [ RR] 0.9, 95% CI 0.4–2.2). The relative risk of limb anomalies among women exposed to β‐blockers was 6.4 (95% CI 0.6–70.1). Exposure to angiotensin‐converting enzyme ( ACE) inhibitors, β‐blockers, and calcium channel blockers increased the risk of genital anomalies ( RR 3.8, 95% CI 0.9–16.0; RR 2.8, 95% CI 0.7–11.9; RR 1.3, 95% CI 0.1–12.4, respectively). Conclusion ACE inhibitors prescribed in the first trimester of pregnancy appeared to increase the risk of congenital anomalies among the offspring of exposed women ( RR 2.5, 95% CI 0.5–13.5). These drugs should be avoided in women planning to become pregnant. A marginally increased risk was also found with exposure to β‐blockers ( RR 1.4, 95% CI 0.6–3.3). These findings are based on small numbers and are not statistically significant.