Features of Renin Angiotensin System Blockade Fetopathy

RAS blockade during pregnancy is associated with renal, pulmonary, cardiac, skeletal, and central nervous system abnormalities.

The renin angiotensin system (RAS) is known to be essential for fetal kidney development. Despite the longstanding FDA warning that RAS blockade may be teratogenic, pregnant women continue to be exposed to RAS blockers.

In a multicenter, retrospective case series, investigators identified 24 children with unexplained renal congenital anomalies and intrauterine exposure to RAS blockers and described their clinical conditions and exposure characteristics. Fourteen children were exposed to angiotensin-converting enzyme inhibitors (ACEIs) and 10 to angiotensin receptor blockers (ARBs) during pregnancy. Results were as follows:

Mean gestational age at birth was 34.6 weeks.
Seven mothers received RAS inhibition only during the first trimester and th…

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

Features of Renin Angiotensin System Blockade Fetopathy

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Reviewing Author