title: Antihypertensive drugs and the risk of congenital anomalies.
abstract: OBJECTIVE
  To estimate the prevalence of congenital anomalies among the offspring of women exposed and unexposed to antihypertensive drugs during early pregnancy.
  
  
  METHODS
  Matched cohort study.
  
  
  METHODS
  The United Kingdom's General Practice Research Database.
  
  
  METHODS
  Women exposed to antihypertensive drugs during early pregnancy and a sample of matched unexposed pregnant women.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Vasilakis-Scaramozza
authors.forename: Ann
authors.initials: A
authors.lastname: Aschengrau
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Cabral
authors.forename: Susan S
authors.initials: SS
authors.lastname: Jick
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000453:epidemiology / Q000209:etiology*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D015995:Prevalence; D012306:Risk; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents