ACE inhibitors-Are they safe in newborns?

http://link.springer.com/article/10.1007%2Fs00246-013-0813-2
Pediatric Cardiology March 2014, Volume 35, Issue 3, pp 499-506

The age range of neonates at ACEi initiation was 15.9–18.1 days. The inclusion criteria was met by 206 neonates: 168 term (82 %) and 38 preterm (18 %) newborns. The mean dose of captopril was 0.07 ± 0.009 mg/kg for the preterm neonates and 0.13 ± 0.019 mg/kg for the term neonates.

Nearly 42 % of all the patients showed renal risk, with approximately 30 % demonstrating renal failure by modified pRIFLE (pediatric risk, injury, failure, loss, and end-stage renal disease) criteria. Despite the lack of significantly different CrCl, the premature neonates were more likely to experience ACEi-related renal failure by pRIFLE (55 %) than their term counterparts (23 %; p < 0.001). Despite its common use for term neonates with cardiac disease, ACEi should be used cautiously and only when indications are clear. These results also raise the question whether ACEi should be used at all for preterm neonates.