PMID- 31909512
OWN - NLM
STAT- MEDLINE
DCOM- 20200828
LR  - 20200828
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 51
IP  - 4
DP  - 2020 Feb
TI  - Systematic review with meta-analysis: the risks of proton pump inhibitors during 
      pregnancy.
PG  - 410-420
LID - 10.1111/apt.15610 [doi]
AB  - BACKGROUND: There have been safety concerns considering long-term proton pump 
      inhibitor (PPI) use, also during pregnancy. AIMS: To assess the risk of adverse 
      neonatal outcomes associated with maternal intake of PPIs by means of systematic 
      review and meta-analysis. METHODS: The systematic search included PubMed, Web of 
      Science, Cochrane Database and Embase (inception until June 2019). All studies 
      reporting >/=1 adverse pregnancy outcome comparing PPI users to non-users. 
      Histamine-2 receptor antagonists (H2RA) were also compared to both non-users and 
      PPI users. Outcomes included congenital malformations, abortion, stillbirth, 
      neonatal death, preterm birth, small for gestational age and low birth weight. 
      Pooled odds ratios (OR) and 95% confidence intervals (CI) were obtained by 
      random-effects modelling. PROSPERO study-protocol: CRD42018103320. RESULTS: In 
      total, 26 observational studies (20 cohort, 6 case-control studies) were 
      identified, of which 19 assessed PPIs and 12 H2RA. PPI use was associated with an 
      increased risk of congenital malformations (OR 1.28, 95% CI 1.09-1.52), 
      especially in case-control studies (OR 2.04, 1.46-2.86). No associations were 
      found between H2RA and congenital malformations. No significant associations were 
      found between PPI use and abortions, stillbirth, neonatal death, preterm birth 
      and low-birth weight, although H2RA use may be associated with an increased risk 
      of preterm birth (OR 1.25, 95% CI 1.02-1.56). Although statistical heterogeneity 
      and the risk of bias were overall low, clinical heterogeneity, information and 
      selection bias may be present in the individual studies. CONCLUSIONS: This 
      meta-analysis suggests an association between maternal PPI use and congenital 
      malformations in humans, yet power was insufficient to assess specific 
      malformations and drugs.
CI  - (c) 2020 John Wiley & Sons Ltd.
FAU - Li, Cheng Mei
AU  - Li CM
AD  - Centre for Translational Microbiome Research, Department of Microbiology, Tumor 
      and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
AD  - Science for Life Laboratory, Stockholm, Sweden.
AD  - Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
FAU - Zhernakova, Alexandra
AU  - Zhernakova A
AD  - Department of Genetics, University of Groningen, University Medical Center 
      Groningen, Groningen, The Netherlands.
FAU - Engstrand, Lars
AU  - Engstrand L
AD  - Centre for Translational Microbiome Research, Department of Microbiology, Tumor 
      and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
AD  - Science for Life Laboratory, Stockholm, Sweden.
FAU - Wijmenga, Cisca
AU  - Wijmenga C
AD  - Department of Genetics, University of Groningen, University Medical Center 
      Groningen, Groningen, The Netherlands.
FAU - Brusselaers, Nele
AU  - Brusselaers N
AUID- ORCID: 0000-0003-0137-447X
AD  - Centre for Translational Microbiome Research, Department of Microbiology, Tumor 
      and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
AD  - Science for Life Laboratory, Stockholm, Sweden.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20200107
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - Aliment Pharmacol Ther. 2020 Aug;52(4):739. PMID: 32886386
CIN - Aliment Pharmacol Ther. 2020 Aug;52(4):740-741. PMID: 32886407
MH  - Abnormalities, Drug-Induced/epidemiology
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Congenital Abnormalities/epidemiology
MH  - Female
MH  - Heartburn/drug therapy/epidemiology
MH  - Histamine H2 Antagonists/adverse effects
MH  - Humans
MH  - Infant, Low Birth Weight
MH  - Infant, Newborn
MH  - Infant, Small for Gestational Age
MH  - Male
MH  - Pregnancy
MH  - Pregnancy Complications/*drug therapy/*epidemiology
MH  - Pregnancy Outcome/*epidemiology
MH  - Premature Birth/epidemiology
MH  - Proton Pump Inhibitors/*adverse effects
MH  - Risk Factors
MH  - Stillbirth/epidemiology
EDAT- 2020/01/08 06:00
MHDA- 2020/08/29 06:00
CRDT- 2020/01/08 06:00
PHST- 2019/09/18 00:00 [received]
PHST- 2019/10/14 00:00 [revised]
PHST- 2019/11/23 00:00 [accepted]
PHST- 2020/01/08 06:00 [pubmed]
PHST- 2020/08/29 06:00 [medline]
PHST- 2020/01/08 06:00 [entrez]
AID - 10.1111/apt.15610 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2020 Feb;51(4):410-420. doi: 10.1111/apt.15610. Epub 2020 
      Jan 7.