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- Page navigation anchor for Pregnancy protection and pregnancies in women prescribed ACE inhibitors or ARBs: a cross-sectional study in primary carePregnancy protection and pregnancies in women prescribed ACE inhibitors or ARBs: a cross-sectional study in primary careWith great interest we have read an article written by Lovegrove et al.1 It was shocking that 81.4% of the women using ACE inhibitor/ARB had no advice and no contraception prescription coded. This finding has a great clinical relevance for which we want to congratulate the authors. Nevertheless, a few questions remain.The study used the Read code system to collect data concerning preconception and contraception advice, contraception and pregnancies from the included general practices (GP). But wouldn’t it be possible that, by using this particular system, many preconception and contraception advices are missed? Especially since the free text was not included.Other studies demonstrated that a valid result could not always be concluded using the Read code system.2-4 In this particular study it is not clear if all GPs always coded their given advice. In addition it might be possible that women received preconception and contraception advice by care received elsewhere or whether their partner has been sterilized or uses (unregistered) condoms. This may underestimate of the amount of given advice. Although this is mentioned shortly in the discussion section, the magnitude of this problem is not mentioned. Doesn’t this cause a major underestimation of the results?Pregnancy coded in the 12 months preceding the index date was used a...Show MoreCompeting Interests: None declared.