ACE Inhibitors Are Appropriate for Most Women

Among U.S. women of childbearing age with chronic hypertension (CHTN), about 40% receive angiotension-converting enzyme (ACE) inhibitors. Although the teratogenicity of ACE inhibitor exposure during the second and third trimesters is well known (e.g., renal failure, fetal skull hypoplasia, neonatal hypotension), the fetal safety of this medication class during the first trimester is debated. Researchers used a database of Medicaid claims from 2002 to 2010 to construct a cohort of some 1.3 million pregnancies resulting in live-born neonates; they then evaluated risk for fetal malformations in those pregnancies complicated by CHTN with or without claims for ACE inhibitor treatment during the first trimester. As the database did not include pr…