{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:00:01Z","timestamp":1791907201852,"version":"4.3.4"},"reference-count":38,"publisher":"Royal College of General Practitioners","issue":"700","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The teratogenic risks of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are well documented, but prescribing these in younger women in primary care is becoming increasingly frequent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To record how frequently women of childbearing age, who are prescribed an ACE inhibitor or ARB, receive preconception advice and\/or are prescribed contraception, and how many pregnancies, terminations, and miscarriages occur in this population. Additionally, to ascertain whether patterns in the above differ across age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>Cross-sectional study conducted among patients from 141 general practices in East London.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Women aged 15\u201345 years who were issued a prescription for an ACE inhibitor or ARB between 1 October 2018 and 1 January 2019 inclusive were included. An electronic search strategy was designed to extract pseudonymised data concerning preconception and contraception advice, contraception, and pregnancies from the electronic clinical system; this was applied to the selected cohort on 1 January 2019. Data were analysed in 5-year age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 302 939 women aged 15\u201345 years, 2651 (0.9%) were prescribed an ACE inhibitor or an ARB in a 3-month period. Of these, 2159 (81.4%) had no advice and no contraception prescription recorded, 35 (1.3%) had preconception advice recorded, and 230 (8.7%) had contraception advice recorded. A total of 100 pregnancies and 21 terminations\/miscarriages were recorded in the 12 months preceding the index date (1 January 2019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study found that the recording of pre-pregnancy advice and contraception in women of childbearing age who were prescribed an ACE inhibitor or an ARB was suboptimal; this may place women and their babies at risk of exposure to teratogens during pregnancy. The findings indicate that there is a need for improved safety strategies based in primary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgp20x712997","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T00:25:27Z","timestamp":1601943927000},"page":"e778-e784","source":"Crossref","is-referenced-by-count":14,"title":["Pregnancy protection and pregnancies in women prescribed ACE inhibitors or ARBs: a cross-sectional study in primary care"],"prefix":"10.3399","volume":"70","author":[{"given":"Elizabeth","family":"Lovegrove","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Robson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"McGettigan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"2021030806051078000_70.700.e778.1","unstructured":"Public Health England (2017) Health matters: combating high blood pressure. https:\/\/www.gov.uk\/government\/publications\/health-matters-combating-high-blood-pressure\/health-matters-combating-high-blood-pressure (accessed 28 Sep 2020)."},{"key":"2021030806051078000_70.700.e778.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.3.475"},{"key":"2021030806051078000_70.700.e778.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-018-0812-z"},{"key":"2021030806051078000_70.700.e778.4","unstructured":"Editor (Jan 15, 2019) Diabetes prevalence. 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