Acid-Suppressive Drug Use During Pregnancy and the Risk of Childhood Asthma: A Meta-analysis.

CONTEXT

The association between acid-suppressive drug exposure during pregnancy and childhood asthma has not been well established.

OBJECTIVE

To conduct a systematic review and meta-analysis on this association to provide further justification for the current studies.

DATA SOURCES

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.

STUDY SELECTION

Observational studies in which researchers assessed acid-suppressive drug use during pregnancy and the risk of childhood asthma were included.

DATA EXTRACTION

Of 556 screened articles, 8 population-based studies were included in the final analyses.

RESULTS

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).

LIMITATIONS

None of the researchers in the studies in this meta-analysis adjusted for the full panel of known confounders in these associations.

CONCLUSIONS

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.