Wegleiter K, Waltner-Romen M, Trawoeger R, Kiechl-Kohlendorfer U, Griesmaier E
Department of Pediatrics II, Neonatology and Neonatal Intensive Care Unit, Medical University of Innsbruck, Innsbruck, Austria.
Case Rep Pediatr. 2018 Jan 11;2018:5412138. doi: 10.1155/2018/5412138. eCollection 2018.
Fetal angiotensin II receptor antagonist exposure is associated with major complications and even death when administered during pregnancy. Neonates frequently require intensive care treatment, and mortality is high. Despite this well-known risk potential, a considerable number of women still receive angiotensin II receptor antagonists during pregnancy to treat arterial hypertension. Although clinical symptoms in the neonatal period are well described, few reports address long-term follow-up after fetal exposure to angiotensin II receptor antagonists. We here report on a patient who was unwittingly exposed to olmesartan medoxomil during pregnancy. After birth, the neonate presented with mild clinical symptoms, mainly affecting the kidneys. However, neurodevelopmental follow-up revealed a delay in motor development with muscular hypotonia and failure to thrive at age 2 years. This case highlights the fact that, despite not causing neurological symptoms in the neonatal period, fetal angiotensin II receptor antagonist exposure during pregnancy might lead to neurodevelopmental impairment in later life.
孕期使用胎儿血管紧张素II受体拮抗剂与主要并发症甚至死亡相关。新生儿常需要重症监护治疗，死亡率很高。尽管存在这种众所周知的潜在风险，但仍有相当数量的女性在孕期接受血管紧张素II受体拮抗剂治疗动脉高血压。虽然新生儿期的临床症状已有详细描述，但关于胎儿暴露于血管紧张素II受体拮抗剂后的长期随访报告却很少。我们在此报告一名患者，其在孕期无意中暴露于奥美沙坦酯。出生后，新生儿出现轻度临床症状，主要影响肾脏。然而，神经发育随访显示，该患儿在2岁时运动发育延迟，伴有肌张力减退和发育不良。该病例凸显了这样一个事实，即尽管在新生儿期未引起神经症状，但孕期胎儿暴露于血管紧张素II受体拮抗剂可能会导致后期神经发育受损。
