Increasing exposure to angiotensin-converting enzyme inhibitors in pregnancy

被引:37
作者
Bowen, Michael E. [1 ]
Ray, Wayne A. [2 ]
Arbogast, Patrick G. [3 ]
Ding, Hua [3 ]
Cooper, William O. [1 ]
机构
[1] Vanderbilt Univ, Sch Med, Dept Pediat, Nashville, TN 37212 USA
[2] Vanderbilt Univ, Sch Med, Dept Prevent Med, Nashville, TN 37212 USA
[3] Vanderbilt Univ, Sch Med, Dept Biostat, Nashville, TN 37212 USA
关键词
angiotensin-converting enzyme inhibitor; pregnancy; prescription; teratogen;
D O I
10.1016/j.ajog.2007.09.009
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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 [Cl], 2.78-7.25). Exposures in the second and third trimesters nearly tripled ( RR, 2.88; 95% Cl, 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.
引用
收藏
页码:291.e1 / 291.e5
页数:5
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