Antihypertensive Drugs and the Risk of Congenital Anomalies. Issue 5 (1st April 2013)

• Record Type: Journal Article
• Authors: Vasilakis‐Scaramozza, Catherine; Aschengrau, Ann; Cabral, Howard J.; Jick, Susan S.
• Is Part Of: Pharmacotherapy. Volume 33:Issue 5(2013)
• Page Start: 476
• Page End: 482
• Publication Date: 2013-04-01
• Subjects: Chemotherapy -- Periodicals; Pharmacology -- Periodicals; Drug Therapy -- Periodicals; Pharmacology -- Periodicals; 615.1
• DOI: 10.1002/phar.1212
• Languages: English
• ISSNs: 0277-0008

Abstract

<abstract abstract-type="main" id="phar1212-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="phar1212-sec-0001" sec-type="section"> <title>Study Objective</title> <p>To estimate the prevalence of congenital anomalies among the offspring of women exposed and unexposed to antihypertensive drugs during early pregnancy.</p> </sec> <sec id="phar1212-sec-0002" sec-type="section"> <title>Design</title> <p>Matched cohort study.</p> </sec> <sec id="phar1212-sec-0003" sec-type="section"> <title>Database</title> <p>The United Kingdom's General Practice Research Database.</p> </sec> <sec id="phar1212-sec-0004" sec-type="section"> <title>Subjects</title> <p>Women exposed to antihypertensive drugs during early pregnancy and a sample of matched unexposed pregnant women.</p> </sec> <sec id="phar1212-sec-0005" sec-type="section"> <title>Measurements and Main Results</title> <p>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).</p> </sec> <sec id="phar1212-sec-0006" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>