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Previous Volume 355:1280-1281 September 21, 2006 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Cooper et al. (June 8 issue)¹ describe an association between first-trimester exposure to angiotensin-converting–enzyme (ACE) inhibitors and congenital malformations. We question whether the authors excluded maternal diabetes mellitus and maternal obesity as explanatory factors. Given the deficiencies of charting and coding in busy medical practices, diabetes in women may not be detected. Women with diabetes mellitus that is poorly documented may have poor glycemic control.

Maternal obesity may also have been a confounder. Obese women may have hypertension that is difficult to control, requiring the use of multiple medications including an ACE inhibitor. Maternal obesity is an . . . [Full Text of this Article]

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