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Taking acid-suppressing drugs during pregnancy may increase the risk of child asthma by as much as 50 percent, according to a large population-based study led by Elizabeth Hait, MD, MPH Edda Fiebiger PhD, and Eleonora Dehlink, MD, PhD, (pictured below), all of Children’s Hosptial Boston’s Division of Gastroenterology/Nutrition.
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, and more than 29,000 (5 percent) had a discharge diagnosis of allergy or prescriptions for allergy medications by 2006. Maternal use of acid-suppressive medicines was associated with a 43 percent greater likelihood that a child would be hospitalized or receive prescriptions for allergic conditions. Asthma was the most commonly reported condition; its likelihood was increased by 51 percent in children of mothers using antacids during pregnancy.
When maternal history of allergy was factored in, the risk associated with acid suppression was increased only if the mother was non-allergic. (The 25 percent increase among children of allergic mothers wasn’t statistically different from chance).
Prior studies have shown that acid-suppressing drugs result in allergic sensitization in adults, and that mice exposed to these medications in utero have greater numbers of the immune cells that predominate in allergic conditions. Dr. Fiebiger, whose laboratory researches immune mechanisms of food allergy, notes that food proteins not completely broken down by stomach acids can potentially be seen as allergens by the immune system.
The study was published online on January 19 by the Journal of Clinical and Experimental Allergy. Although confirmation is needed, Dr. Hait suggests that pregnant women avoid acid-suppressive medications if possible, unless reflux makes them unable to eat and non-drug approaches aren’t working.
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