Developmental toxicity of the angiotensin II type 1 receptor antagonists during human pregnancy: a report of 10 cases

Objective Angiotensin II type I receptor antagonists (ARA). Interacted with the renin-angiotensin system, and the present study was undertaken to examine their fetal and neonatal toxicity when taken by the mother during pregnancy. Design Prospective follow up of pregnant women exposed to an ARA during early pregnancy. Setting The present study was conducted in the departments of Paediatric Pharmacology of the University hospital Robert Debre in Paris, France. Population Ten women exposed to an ARA during early pregnancy. Methods Prospective follow up. Main outcome measure Fetal ultrasonography and outcome of pregnancy. Results Prenatal ultrasonography showed abnormal features in five cases (oligoamnios related to fetal tabular dysgenesis, fetal dysmorphia and renal abnormalities). Outcome of pregnancy was as follows: three induced abortions, two stillbirths (twin pregnancy), one neonate presenting with dysmorphia and renal disease and five neonates with an uneventful development. Conclusion Women of reproductive age should be advised of the possible hazards of ARA and treatment should be stopped as soon as pregnancy has been documented.