{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:57:31Z","timestamp":1792979851574,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Innovation Fund of the German Joint Federal Committee","award":["01VSF16010"],"award-info":[{"award-number":["01VSF16010"]}]},{"name":"Leibniz-Institut f\u00fcr Pr\u00e4ventionsforschung und Epidemiologie \u2013 BIPS GmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although use of inhibitors of the renin\u2013angiotensin\u2013aldosterone system (RAAS-I) is contraindicated in the second and third trimesters of pregnancy, a relevant number of pregnancies is still exposed. Fetopathy in children exposed after gestational week (GW) 20 is well described, but data on long-term outcomes are scarce. Our study aims to describe postnatal and long-term outcomes after fetal exposure to RAAS-I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included all pregnancies in the German Pharmacoepidemiological Research Database GePaRD (claims data; 20% of the total German population) with exposure to RAAS-I or the antihypertensives recommended during pregnancy, i.e., metoprolol or methyldopa (HYP) after GW 20. We assessed diagnoses characteristic of RAAS-I-related fetopathy in the first 180\u00a0days after birth and examined long-term outcomes of children with and without neonatal fetopathy, especially hypertension and kidney disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, we identified 203 live born children exposed to RAAS-I, of whom 61 were exposed to angiotensin II receptor blockers (ARBs), and 29,674 live born children exposed to HYP. Diagnoses consistent with RAAS-I-related fetopathy were seen in eight of the RAAS-I exposed newborns (3.9%) and in seven of the 61 ARB-exposed newborns (11.5%). Median follow-up in children without fetopathy was 4.0\u00a0years in both exposure groups. Among non-fetopathy children exposed to RAAS-I, three (1.5%) were diagnosed with hypertension or received antihypertensive prescriptions, compared to 176 children (0.6%) exposed to HYP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Risk of fetopathy is higher after fetal exposure to ARBs than to angiotensin-converting enzyme inhibitors. In a small proportion of children, sequelae of fetal RAAS-I exposure might only manifest in the years following birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-025-07101-9","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T19:26:54Z","timestamp":1765999614000},"page":"1387-1397","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Postnatal and long-term outcomes after in utero exposure to RAAS inhibitors: cohort study based on German claims data"],"prefix":"10.1007","volume":"41","author":[{"given":"Tania","family":"Schink","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte","family":"Braitmaier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Dathe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Haug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Schaefer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Th\u00f6ne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies","family":"Onken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"7101_CR1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0306547","volume":"19","author":"Y Wang","year":"2024","unstructured":"Wang Y, Smolinski NE, Ewig C, Thai TN, Wen TS, Winterstein AG (2024) Antihypertensive utilization patterns among pregnant persons with pre-existing hypertension in the US: a population-based study. 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Unrelated to this study, BIPS occasionally conducts post-authorization safety studies (PASS) requested by health authorities and financed by the pharmaceutical industry. These PASS are performed in line with the ENCePP Code of Conduct, which means that the design and conduct as well as the interpretation and publication are not influenced by the pharmaceutical industry. The study presented was not funded by the pharmaceutical industry. KD, MO, and CS are staff members of the Berlin Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy which is financially supported by the German Federal Institute for Drugs and Medical Devices (BfArM). KT works for the Techniker Krankenkasse and has no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}