Renin-angiotensin system (ACEIs and/or ARBs) (versus unexposed) updated on 03-11-2025

Table   Graphic     exposition period:

Congenital malformations
Adverse outcome OR 95%CII2k No. casesNo. exposedpublication biasROBE-value
All congenital malformations (majors, minors, majors and minors, or unspecified)1.66 [1.21, 2.30]69%14 studies29,8064,726critical ROB2.72 [1.70; .]
Major congenital malformations1.68 [1.21, 2.34]71%13 studies29,8024,618critical ROB2.76 [1.71; .]
Congenital heart defects2.17 [1.27, 3.72]80%9 studies14,2184,017serious ROB3.76 [1.85; .]
Coarctation of aorta3.76 [0.85, 16.59]19%2 studies98not evaluable ROB-
Atrial septal defect2.70 [1.44, 5.05]-1 study21not evaluable ROB4.84 [2.24; .]
Pulmonary valve stenosis2.78 [0.99, 7.79]-1 studynot evaluable ROB-
Ebstein's anomaly26.40 [2.29, 304.51]-1 study654not evaluable ROB52.30 [4.01; .]
Hypospadias1.23 [0.43, 3.50]8%2 studies2,13165not evaluable ROB-
Nervous system anomalies1.46 [0.19, 11.38]89%2 studies832,840not evaluable ROB-
Urinary malformations4.01 [1.39, 11.58]3%3 studies5548not evaluable ROB7.48 [2.12; .]
Genital anomalies5.73 [2.64, 12.42]0%2 studies5130not evaluable ROB10.93 [4.72; .]
Neural Tube Defects0.86 [0.37, 2.01]-1 study287652not evaluable ROB-
Ventricular septal defect6.91 [1.43, 33.35]-1 studynot evaluable ROB13.30 [2.22; .]
Ano-rectal atresia and stenosis2.20 [0.50, 9.65]-1 study782not evaluable ROB-
Chromosomal abnormalities14.76 [3.64, 59.81]-1 study84not evaluable ROB29.01 [6.74; .]
Cleft palate1.40 [0.48, 4.11]-1 study1,445not evaluable ROB-
Down syndrom / Trisomy 219.56 [2.20, 41.59]-1 study84not evaluable ROB18.61 [3.82; .]
Gastroschisis1.30 [0.34, 5.03]-1 study1,327not evaluable ROB-
Oesophageal atresia with or without tracheo-oesophageal fistula2.70 [0.63, 11.52]-1 study660not evaluable ROB-

Growth parameters and prematurity
Adverse outcome OR 95%CII2k No. casesNo. exposedpublication biasROBE-value
Preterm (< 37 weeks)2.83 [2.04, 3.94]71%8 studies38,6561,267not evaluable ROB5.11 [3.49; .]
Small for gestational age (weight)2.05 [1.21, 3.49]0%4 studies8,156222not evaluable ROB3.52 [1.71; .]
Low birth weight (< 2500g)2.39 [1.71, 3.34]48%3 studies27,5331,318not evaluable ROB4.21 [2.82; .]
Extremely preterm (< 28 weeks)1.92 [0.12, 31.85]-1 study3542not evaluable ROB-
Very preterm (28 to 32 weeks)3.40 [1.04, 11.15]-1 study12942not evaluable ROB6.26 [1.23; .]

Maternal consequences
Adverse outcome OR 95%CII2k No. casesNo. exposedpublication biasROBE-value
Caesarean2.01 [1.62, 2.50]0%2 studies2,681159not evaluable ROB3.43 [2.61; .]
Postpartum hemorrhage0.39 [0.02, 6.38]-1 study17042not evaluable ROB-
Preeclampsia2.08 [0.82, 5.27]62%2 studies256782not evaluable ROB-
Gestational diabetes0.85 [0.12, 6.21]-1 study16042not evaluable ROB-
Maternal consequences (as a whole)1.22 [0.88, 1.68]-1 study2412,520not evaluable ROB-

Neonatal disorders
Adverse outcome OR 95%CII2k No. casesNo. exposedpublication biasROBE-value
Feeding difficulty0.64 [0.29, 1.41]-1 study7,03084not evaluable ROB-
Fetal distress--0 study-
Jaundice / Icterus2.66 [1.51, 4.68]-1 study7,60584not evaluable ROB4.76 [2.39; .]
Low Apgar score (< 7) (at 5 min)0.67 [0.16, 2.79]-1 study39742not evaluable ROB-
Low Apgar score (< 7) (NOS)1.08 [0.76, 1.54]-1 study34not evaluable ROB-
Neonatal death (< 28 days of life)4.32 [0.58, 32.35]-1 study3342not evaluable ROB-
Neonatal medical care--0 study-

Intrauterine deaths
Adverse outcome OR 95%CII2k No. casesNo. exposedpublication biasROBE-value
Early intrauterine deaths (< 22 weeks) / Spontaneous abortions1.41 [1.07, 1.84]6%6 studies5161,128not evaluable ROB2.16 [1.35; .]
Late intrauterine deaths (> 22 weeks) / Stillbirths2.13 [0.84, 5.42]0%6 studies871,086not evaluable ROB-
Elective/induced termination of pregnancy2.80 [1.42, 5.52]66%5 studies1941,068not evaluable ROB5.05 [2.19; .]
Therapeutic terminations of pregnancy4.65 [1.41, 15.33]0%3 studies27382not evaluable ROB8.76 [2.17; .]
Ectopic pregnancy5.92 [0.24, 145.91]-1 study1252not evaluable ROB-

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