Antihypertensive Medication Use During Pregnancy and the Risk of Cardiovascular Malformations

Caton, Alissa R.; Bell, Erin M.; Druschel, Charlotte M.; Werler, Martha M.; Lin, Angela E.; Browne, Marilyn L.; McNutt, Louise‐Anne; Romitti, Paul A.; Mitchell, Allen A.; Olney, Richard S.; Correa, Adolfo

doi:10.1161/hypertensionaha.109.129098

Cited by 115 publications

(115 citation statements)

References 44 publications

Supporting

Mentioning

109

Contrasting

Order By: Relevance

“…Moreover, mothers exposed to certain antihypertensve drugs are at increased risk of delivering infants with cardiovascular malformations. 37 The current study also showed that maternal epilepsy and mood disorders were associated with an increased risk of congenital heart dis ease in infants. Previous studies have shown that the use of certain anticonvulsants, 38 tran quilizers 39 or hypnotics 40 is associated with an increased risk of congenital heart disease in off spring.…”

Section: Discussionsupporting

confidence: 62%

Association of maternal chronic disease with risk of congenital heart disease in offspring

Chou

Chiou

Liang

et al. 2016

CMAJ

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 62%

Association of maternal chronic disease with risk of congenital heart disease in offspring

Chou

Chiou

Liang

et al. 2016

CMAJ

View full text Add to dashboard Cite

show abstract

“…5 Although treatment with medication might benefit the mother, it carries potential risks to the fetus from both impaired utero-placental perfusion and foetal exposure to the medications. 6 Study of prescribing pattern is a component of medical audit which seeks monitoring, evaluation and necessary modifications in the prescribing practices of the prescribers to achieve rational and cost effective medical care. Thus, the monitoring of prescription and drug utilization studies can identify the problems and provide feedback to prescribers so as to create awareness about irrational.…”

Section: Introductionmentioning

confidence: 99%

Analysis of prescribing pattern of antihypertensive drugs during pregnancy and neonatal outcome in a tertiary care centre

Yamakanamardi

et al. 2016

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

INTRODUCTIONHypertensive disorders are the most common medical complications of pregnancy with an incidence of 2 to 8 %.1,2 It is one of the major causes of maternal and perinatal morbidity and mortality worldwide. There are several major categories of hypertensive disorders in pregnancy ranging from mild to moderate rise in blood pressure without proteinuria usually called pregnancy induced hypertension (PIH), preeclampsia (hypertension with proteinuria), severe preeclampsia and eclampsia. Maternal hypertension, even of the mild to moderate category, can lead to adverse perinatal outcomes like low birth weight, prematurity, stillbirth and intrauterine growth retardation.3 Though hypertension occurs in 2 to 8% of pregnancies, yet information on the safety of antihypertensive medication use during pregnancy is limited. For severe hypertension, anti-hypertensive medication is used to prevent serious maternal and foetal complications; however, there is no consensus on when to treat mild-to-moderate hypertension. According to ACOG (American college of gynaecology) technical bulletin recommends that drugs not to be administered in pregnancy associated with hypertension, if systolic BP is less than 160 and diastolic BP less than 110. 4 Hypertensive pregnant mothers are at increased risks for premature delivery, intrauterine foetal death, growth retardation and abruptio placentae; they also have an increased risk of vascular injury with thrombotic microangioplasty, coagulopathy, cerebral haemorrhage, and multi organ injury especially of kidney and liver. So as to avoid all such complications, it is better to start the treatment with antihypertensive after assessing correct stage and class of hypertension and always prescribe the safe drug to avoid adverse effects over the foetus and ABSTRACT Background: Hypertensive disorders are the most common medical complications of pregnancy with an incidence of 2-8%. Maternal hypertension, even of the mild to moderate category, can lead to adverse perinatal outcomes like low birth weight, prematurity, stillbirth and intrauterine growth retardation. Though hypertension occurs up to 8% of pregnancies, yet information on the safety of antihypertensive medication use during pregnancy is limited. The objective of this study was to analyse the prescription pattern of antihypertensive drugs in pregnant woman and also to assess the neonatal outcome in pregnant woman on antihypertensive drugs. Methods:The retrospective study includes analysis of all the prescriptions from case records of hypertensive pregnant women till the delivery for one year. Results: Total number of 122 hypertensive pregnant patients was included in the study. Mean age of the patients was 25.8 years. 51.6% were primigravida. Most of them were diagnosed after 28±2 weeks of pregnancy. 54% were on monotherapy. Most commonly used drug was alpha methyl dopa followed by nifedipine. Out of 86.9% (n=106) live birth delivered; 29.2% were of low birth weight. Conclusions: All the prescriptions were prescribed rationally. Most ...

show abstract

“…4 Similar findings were reported in a smaller Swedish cohort study 5 and a large casecontrol US study. 6 Maternal exposure to angiotensin converting enzyme inhibitors in the first trimester and risk of malformations in offspring: a retrospective cohort study Li et al BMJ 2011;343:d5931 Researchers examined 465,754 mother -infant pairs for the reported link between the use of ACE inhibitors in the first trimester and birth defects. This population based, retrospective cohort study linked automated clinical and pharmacy databases, including comprehensive electronic medical records.…”

mentioning

confidence: 99%

Fetal risk from angiotensin converting enzyme inhibitors in the first trimester

Hotham

2012

Obstet Med

View full text Add to dashboard Cite

In 1980, published animal data in The Lancet flagged concerns with the angiotensin converting enzyme (ACE) inhibitor captopril. 1 Publications on the safety of ACE inhibitors followed in the 1980s. By 1993, ACE inhibitor fetopathy had been described in the offspring of patients who took these drugs in the second and third trimesters. The adverse outcomes were deliberately called fetopathy rather than teratogenicity at that time. 2 A 2006 report raised further concerns by demonstrating an association of ACE inhibitors used in the first trimester of pregnancy with an increased rate of birth defects, in particular cardiac malformations and neural tube defects. Other antihypertensive drugs were not associated with increased risks in birth defects. 3 However, in 2011 Li et al., in a retrospective cohort study with a much larger population base and a more ethnically diverse population, did not confirm the reported findings. The study showed that hypertension itself appears to be a modest risk for birth defects, particularly cardiac. 4 Similar findings were reported in a smaller Swedish cohort study 5 and a large casecontrol US study. 6

show abstract

Antihypertensive Medication Use During Pregnancy and the Risk of Cardiovascular Malformations

Cited by 115 publications

References 44 publications

Association of maternal chronic disease with risk of congenital heart disease in offspring

Association of maternal chronic disease with risk of congenital heart disease in offspring

Analysis of prescribing pattern of antihypertensive drugs during pregnancy and neonatal outcome in a tertiary care centre

Fetal risk from angiotensin converting enzyme inhibitors in the first trimester

Contact Info

Product

Resources

About