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Up to 85 percent of pregnant women suffer acid reflux, or heartburn, leading some to take antacids to relieve their symptoms. But a large population-based study suggests that exposure to these drugs in utero might increase a child's risk for asthma. The findings are published in the February issue of the journal Clinical and Experimental Allergy.
Eleonora Dehlink, MD, PhD, Elizabeth Hait, MD, MPH, and Edda Fiebiger, PhD, all in Children's Hospital Boston's Division of Gastroenterology/Nutrition, examined mother-child allergy relationships using three national health registers in Sweden: the Medical Birth Register, the Hospital Discharge Register and the Prescribed Drug Register. By linking these databases, the team could identify mothers who took acid-blocking drugs during pregnancy and children who were hospitalized for allergic disorders or received a prescription for allergies—then trace the children back to their mothers.
Of more than 585,000 children born between 1995 and 2004, about 5,600 (just under 1 percent) had been exposed to acid suppression therapy during pregnancy. These children were 43 percent more likely than non-exposed children to be hospitalized or receive prescriptions for allergic conditions, particularly asthma, which had a 51 percent greater likelihood of occurring.
Most of the increased risk, however, was in children of mothers who didn't themselves have allergies. Children whose mothers are allergic are already at high risk for allergies, so the increase due to antacids was minimal.
Acid suppression has already been shown to cause allergic sensitization in adults. Fiebiger, whose laboratory researches the immune mechanisms of food allergy, speculates that if proteins aren't broken down completely by stomach acid, the immune system can potentially recognize them as allergens.
However, the researchers aren't suggesting that all pregnant women stop taking acid-suppressing medications. "Some women have such severe acid reflux they can't eat," says Hait. "That is obviously not good for the baby either. Each woman, with the guidance of her physician, should weigh the potential risks and benefits of taking acid-suppressive medication, but should attempt dietary and lifestyle modifications first."
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