ACE Inhibitors Are Teratogenic in the First Trimester

ACE inhibitors, long known to be teratogenic when used in the last two trimesters of pregnancy, have been considered safe in the first trimester. However, this assumption has been based on relatively limited data. These researchers analyzed medication-use and other data from Medicaid recipients in Tennessee to assess whether first-trimester exposure to ACE inhibitors is associated with congenital malformations.

Of 29,507 analyzed births, 411 involved exposure to antihypertensive drugs only during the first trimester (209 to ACE inhibitors, 202 to other antihypertensives not specified in the article). Overall, 856 infants (2.9%) had congenital malformations that were not related to a chromosomal defect or a clinical genetic syndrome.

Congenita…