Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, School of Medicine, Zhejiang University, Zhejiang Sheng, China.
Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, The Affiliated Hospital of Guangdong Medical University, Guangdong Sheng, China.
Pediatrics. 2018 Feb;141(2). doi: 10.1542/peds.2017-0889. Epub 2018 Jan 11.
The association between acid-suppressive drug exposure during pregnancy and childhood asthma has not been well established.
To conduct a systematic review and meta-analysis on this association to provide further justification for the current studies.
We searched PubMed, Medline, Embase, the Cochrane Database of Systematic Reviews, EBSCO Information Services, Web of Science, and Google Scholar from inception until June 2017.
Observational studies in which researchers assessed acid-suppressive drug use during pregnancy and the risk of childhood asthma were included.
Of 556 screened articles, 8 population-based studies were included in the final analyses.
When all the studies were pooled, acid-suppressive drug use in pregnancy was associated with an increased risk of asthma in childhood (relative risk [RR] = 1.45; 95% confidence interval [CI] 1.35-1.56; I = 0%; < .00001). The overall risk of asthma in childhood increased among proton pump inhibitor users (RR = 1.34; 95% CI 1.18-1.52; I = 46%; < .00001) and histamine-2 receptor antagonist users (RR = 1.57; 95% CI 1.46-1.69; I = 0%; < .00001).
None of the researchers in the studies in this meta-analysis adjusted for the full panel of known confounders in these associations.
The evidence suggests that prenatal, maternal, acid-suppressive drug use is associated with an increased risk of childhood asthma. This information may help clinicians and parents to use caution when deciding whether to take acid-suppressing drugs during pregnancy because of the risk of asthma in offspring.
酸抑制药物在怀孕期间的暴露与儿童哮喘之间的关联尚未得到很好的确定。
对这一关联进行系统评价和荟萃分析，为当前研究提供进一步的依据。
我们检索了 PubMed、Medline、Embase、Cochrane 系统评价数据库、EBSCO 信息服务、Web of Science 和 Google Scholar，检索时间从建库至 2017 年 6 月。
纳入了评估孕妇怀孕期间使用酸抑制药物与儿童哮喘风险的观察性研究。
在 556 篇筛选出的文章中，有 8 项基于人群的研究纳入最终分析。
当所有研究合并时，怀孕期间使用酸抑制药物与儿童哮喘的风险增加相关（相对风险 [RR] = 1.45；95%置信区间 [CI] 1.35-1.56；I = 0%；<0.00001）。质子泵抑制剂使用者（RR = 1.34；95% CI 1.18-1.52；I = 46%；<0.00001）和组胺 2 受体拮抗剂使用者（RR = 1.57；95% CI 1.46-1.69；I = 0%；<0.00001）的儿童哮喘总体风险增加。
本荟萃分析中纳入的研究的研究人员均未针对这些关联中的所有已知混杂因素进行全面板调整。
证据表明，产前、母亲、酸抑制药物的使用与儿童哮喘的风险增加相关。这一信息可能有助于临床医生和家长在决定是否在怀孕期间使用酸抑制药物时谨慎行事，因为这会增加后代患哮喘的风险。
