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

Abstract

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; I² = 0%; <i>P</i> < .00001). The overall risk of asthma in childhood increased among proton pump inhibitor users (RR = 1.34; 95% CI 1.18-1.52; I² = 46%; <i>P</i> < .00001) and histamine-2 receptor antagonist users (RR = 1.57; 95% CI 1.46-1.69; I² = 0%; <i>P</i> < .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.