For maternal exposure during the first trimester only, use of ACE inhibitors was associated with about 20% increased risk of any malformations in offspring compared with normal controls (34/400 (8.5%) v 22 429/416 218 (5.4%) cases), though this was not statistically significant.
The similarity existed for antihypertensive use during the first trimester as well as during other periods of pregnancy, although the association between ACE inhibitor use in the first trimester only and the risk of any malformations no longer existed in this group (tables 3).
28 In the US, between the 1970s and the 1990s, use of ultrasonography or amniocentesis for prenatal diagnosis has increased from 7% to nearly 90%, while the rate of elective abortions for any malformation increased from 0.8% to 18%, with a larger absolute increase among terminations for nonfatal malformations.
A live-born infant (3,250 g, 52 cm) had Apgar score of 9 without any malformations observed on physical examination.
Although ACE inhibitor use during the second or third trimesters only showed a similar pattern of association with any malformations, congenital heart defects, or neural tube defects as that shown by use of ACE inhibitors and other antihypertensives during the first trimester (table 2), it was also associated with a noticeably higher risk of malformations.
Next, we examined the relationship between the timing of Canephron® N administration in the first trimester of pregnancy and the presence of any congenital malformations in the newborn (Table 3).
Table 3 shows the absolute number and prevalence of infants with any malformation, noncardiac malformation, cardiac malformation, and septal heart defect according to maternal use of different types of antidepressants.
The risk of any major malformation for women with paused exposure to an SSRI during pregnancy was, adjusted OR 1.27 (95% CI 0.91 to 1.78), compared with unexposed pregnancies.
Excluding these 75 matched pairs did not appreciably change the adjusted relative risks for the main maternal and perinatal outcomes or for the outcome of any congenital malformation (supplementary table S5).
No termination of pregnancy was performed for any of the malformations in the false-positive group, for none of them suggested that "there was a strong probability that the child to be born would have a severe condition recognized as incurable at diagnosis," the criterion for termination under French law.
Surprisingly, this change was not observed in the prevalence of any other congenital malformations.
