Can captopril cause fetal and neonatal renal failure?

We present a case of neonatal renal failure following a pregnancy complicated by hypertension treated with captopril. Clinical investigations showed structurally normal kidneys, suggesting a renal dysfunction other than that seen with the more common causes of neonatal renal failure. Recent animal and human data would support our hypothesis that transplacental captopril could have produced the clinical picture seen in our patient. Our findings do not unequivocally implicate captopril as the offending agent; however, since captopril is not considered to be teratogenic, a more widespread use may be anticipated in pregnancies complicated by severe hypertension. Surveillance of such pregnancies may yield more information regarding the above association.