Improved safety measures needed when prescribing renin-angiotensin inhibitors in younger women, say researchers

The recording of pre-pregnancy advice and contraception in primary care for women of childbearing age prescribed ACE inhibitors or angiotensin II antagonists was found to be sub-optimal in a recent study.

The prescribing of ACE inhibitors and angiotensin II antagonists in younger women in primary care is becoming more frequent despite the teratogenic risks associated with these drugs. | GETTY IMAGES
The prescribing of ACE inhibitors and angiotensin II antagonists in younger women in primary care is becoming more frequent despite the teratogenic risks associated with these drugs. | GETTY IMAGES

The researchers conducted a cross-sectional study involving 141 general practices in East London, identifying 302,939 women aged 15 to 45 years. Of these, 2,651 (0.9%) were prescribed an ACE inhibitor or an angiotensin II inhibitor over a three-month period from 1st October 2018 to 1st January 2019.

The researchers found that for 81.4% (2,159) of these women no advice and no contraception prescription were recorded. Preconception advice and contraception advice were recorded for 1.3% (35) and 8.7% (230) of women, respectively.

A total of 100 pregnancies and 21 terminations or miscarriages were also identified in the 12 months preceding 1st January 2019.

The researchers conclude that the inadequate recording of pre-pregnancy advice and contraception identified in the study may place women and their babies at risk of exposure to teratogens during pregnancy indicating a need for improved safety strategies based in primary care.

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