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Population-based cohort study : proton pump inhibitor use during pregnancy in Sweden and the risk of maternal and neonatal adverse events

(2022) BMC MEDICINE. 20(1).
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Abstract
Background: Approximately half of all women suffer from heartburn at some stage during pregnancy. The most effective treatment is proton pump inhibitors, but the safety of use during pregnancy cannot be guaranteed. This study aimed to elucidate the effect of proton pump inhibitors on the risk of pre-eclampsia, gestational diabetes mellitus, preterm birth, an Apgar score at 5 min below 7, and a child being small or large for its gestational age. Methods: This Swedish population-based study included 1,089,514 live singleton deliveries between July 2006 and December 2016 in Sweden. Multiple logistic regression was used to model the outcomes as a function of the covariates. Results were presented as odds ratios with 95% confidence intervals. Results: In 1.4% of all pregnancies, the mother used proton pump inhibitors in the period from 3 months before the last menstrual period up to delivery. The use of proton pump inhibitors was associated with higher odds of pre-eclampsia (odds ratio = 1.19, 1.10-1.29), gestational diabetes mellitus (odds ratio = 1.29, 1.16-1.43), preterm birth (odds ratio = 1.23, 1.14-1.32), and small for gestational age (odds ratio = 1.27, 1.16-1.40) and lower odds of large for gestational age (odds ratio = 0.84, 0.77-0.91). No significant association was found with a low Apgar score 5 min after birth. Conclusions: Proton pump inhibitor use was associated with a higher risk of pre-eclampsia, gestational diabetes, preterm birth, and being born small for gestational age.
Keywords
WOMEN, REGISTER, OUTCOMES, SAFETY, ADULTS, DRUGS, Proton pump inhibitors, Pregnancy, Maternal and neonatal health, Logistic regression

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MLA
Breddels, Esmee M., et al. “Population-Based Cohort Study : Proton Pump Inhibitor Use during Pregnancy in Sweden and the Risk of Maternal and Neonatal Adverse Events.” BMC MEDICINE, vol. 20, no. 1, BMC, 2022, doi:10.1186/s12916-022-02673-x.
APA
Breddels, E. M., Simin, J., Fornes, R., Engstrand, H. L., Engstrand, L., Bruyndonckx, R., & Brusselaers, N. (2022). Population-based cohort study : proton pump inhibitor use during pregnancy in Sweden and the risk of maternal and neonatal adverse events. BMC MEDICINE, 20(1). https://doi.org/10.1186/s12916-022-02673-x
Chicago author-date
Breddels, Esmee M., Johanna Simin, Romina Fornes, Helene Lilja Engstrand, Lars Engstrand, Robin Bruyndonckx, and Nele Brusselaers. 2022. “Population-Based Cohort Study : Proton Pump Inhibitor Use during Pregnancy in Sweden and the Risk of Maternal and Neonatal Adverse Events.” BMC MEDICINE 20 (1). https://doi.org/10.1186/s12916-022-02673-x.
Chicago author-date (all authors)
Breddels, Esmee M., Johanna Simin, Romina Fornes, Helene Lilja Engstrand, Lars Engstrand, Robin Bruyndonckx, and Nele Brusselaers. 2022. “Population-Based Cohort Study : Proton Pump Inhibitor Use during Pregnancy in Sweden and the Risk of Maternal and Neonatal Adverse Events.” BMC MEDICINE 20 (1). doi:10.1186/s12916-022-02673-x.
Vancouver
1.
Breddels EM, Simin J, Fornes R, Engstrand HL, Engstrand L, Bruyndonckx R, et al. Population-based cohort study : proton pump inhibitor use during pregnancy in Sweden and the risk of maternal and neonatal adverse events. BMC MEDICINE. 2022;20(1).
IEEE
[1]
E. M. Breddels et al., “Population-based cohort study : proton pump inhibitor use during pregnancy in Sweden and the risk of maternal and neonatal adverse events,” BMC MEDICINE, vol. 20, no. 1, 2022.
@article{01GSSQZWQJA2JWEWVPGKK64Y58,
  abstract     = {{Background: Approximately half of all women suffer from heartburn at some stage during pregnancy. The most effective treatment is proton pump inhibitors, but the safety of use during pregnancy cannot be guaranteed. This study aimed to elucidate the effect of proton pump inhibitors on the risk of pre-eclampsia, gestational diabetes mellitus, preterm birth, an Apgar score at 5 min below 7, and a child being small or large for its gestational age. Methods: This Swedish population-based study included 1,089,514 live singleton deliveries between July 2006 and December 2016 in Sweden. Multiple logistic regression was used to model the outcomes as a function of the covariates. Results were presented as odds ratios with 95% confidence intervals. Results: In 1.4% of all pregnancies, the mother used proton pump inhibitors in the period from 3 months before the last menstrual period up to delivery. The use of proton pump inhibitors was associated with higher odds of pre-eclampsia (odds ratio = 1.19, 1.10-1.29), gestational diabetes mellitus (odds ratio = 1.29, 1.16-1.43), preterm birth (odds ratio = 1.23, 1.14-1.32), and small for gestational age (odds ratio = 1.27, 1.16-1.40) and lower odds of large for gestational age (odds ratio = 0.84, 0.77-0.91). No significant association was found with a low Apgar score 5 min after birth. Conclusions: Proton pump inhibitor use was associated with a higher risk of pre-eclampsia, gestational diabetes, preterm birth, and being born small for gestational age.}},
  articleno    = {{492}},
  author       = {{Breddels, Esmee M. and Simin, Johanna and  Fornes, Romina and  Engstrand, Helene Lilja and  Engstrand, Lars and Bruyndonckx, Robin and Brusselaers, Nele}},
  issn         = {{1741-7015}},
  journal      = {{BMC MEDICINE}},
  keywords     = {{WOMEN,REGISTER,OUTCOMES,SAFETY,ADULTS,DRUGS,Proton pump inhibitors,Pregnancy,Maternal and neonatal health,Logistic regression}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{10}},
  publisher    = {{BMC}},
  title        = {{Population-based cohort study : proton pump inhibitor use during pregnancy in Sweden and the risk of maternal and neonatal adverse events}},
  url          = {{http://doi.org/10.1186/s12916-022-02673-x}},
  volume       = {{20}},
  year         = {{2022}},
}

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