Acid-suppressive medications during pregnancy and risk of asthma and allergy in children: A systematic review and meta-analysis

Publication

Journal of Allergy and Clinical Immunology

Author(s)

Rebecca E. Devine, MPH, Nicola McCleary, PhD, Aziz Sheikh, MD, Bright I. Nwaru, PhD

Abstract

Acid-suppressive medications, such as H2-receptor antagonists (H2RA) and proton pump inhibitors (PPI), are the main treatment options for dyspepsia and gastroesophageal reflux disease. These are common problems in pregnancy.1 Recently, concerns have been raised that prenatal exposure to these medications may increase the risk of allergic disease in the offspring. Dehlink et al were the first to report these associations, proposing that use of acid-suppressive medications in pregnancy may increase the risk of allergic disease in the offspring through interference with maternal digestion of labile antigens, thereby increasing the amount of allergen to which the fetus is exposed. PPI use has also been linked to changes in the intestinal microbiota composition, which may also increase the risk of TH2-mediated conditions, such as asthma and allergy. Dehlink et al therefore proposed that acid-suppressive medications could operate through 1 or both of these mechanisms, inducing a TH2 cytokine pattern in mothers that could then cross the fetal membrane and induce sensitization of fetal immune cells to food and airborne allergens prior to birth…

Date

March 3, 2017

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