ACE Inhibitors During Pregnancy Shown to Cause Birth Defects

Even in the first trimester of pregnancy, a class of blood pressure medications called ACE inhibitors may not be safe for the developing fetus. In a new study of nearly 30,000 pregnant women, 7% of babies born developed severe birth defects when their mother took an ACE inhibitor drug early in pregnancy.

A black box warning already alerts women not to take them during the second and third trimesters. The risk of developing birth defects was shown to be three times as high in women taking part in this study.


Defects found in babies of women taking ACE inhibitors in early pregnancy involved the heart (33%), limbs or face (25%), kidneys (no numbers given), brain or spinal cord (10%). Many of these problems are curable with surgery, while others can cause permanent disability or retardation.

ACE inhibitors are the second most commonly prescribed type of medications in the U.S., with 149 million prescriptions written last year. Hypertensive women attempting to become pregnant should ask their doctors for a different type of blood pressure medication.

Among those who took another anti-hypertensive drug, only 1.7% had babies with defects. Women in the group taking no blood pressure medicine had birth defects in 2.6% of babies.

More information is needed about the safety of ACE inhibitors during early pregnancy. In the meantime, women trying to conceive would be advised to stay away from this category of drugs to control high blood pressure. If possible, they should attempt to achieve healthy levels of blood pressure before getting pregnant.

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