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First evidence of a possible association between gastric acid suppression during pregnancy and childhood asthma: a population‐based register study

2008; Wiley; Volume: 39; Issue: 2 Linguagem: Inglês

10.1111/j.1365-2222.2008.03125.x

1365-2222

Eleonora Dehlink, Elizabeth H. Yen, Alan M. Leichtner, Elizabeth J. Hait, Edda Fiebiger,

Respiratory and Cough-Related Research

Summary Background Recent data in mice suggest that acid suppression during pregnancy yields offspring with type 2 T helper‐dominant immunity, suggesting a predisposition for allergy. Objective To determine the association of in utero exposure to acid‐suppressive medications and the subsequent development of allergic diseases in children. Methods We studied a population‐based observational cohort formed by linking data from three Swedish national healthcare registers: the Medical Birth Register, the Hospital Discharge Register, and the Swedish Prescribed Drug Register. Main outcome measures included a hospital discharge diagnosis of an allergic disease or prescription for asthma medications, epinephrine auto‐injectors, antihistamines or steroid ointments in children. Data were analysed using the Mantel–Haenszel procedure. Results Twenty‐nine thousand four hundred and ninety (5.03%) children had a discharge diagnosis of allergy or prescriptions for allergy medications. Five thousand six hundred and forty‐five (0.96%) children had been exposed to acid suppression therapy during pregnancy; of these, 405 (0.07%) were treated for allergic diseases. Exposure to acid‐suppressive medications in utero was associated with an increased odds ratio (OR) for developing allergy (OR 1.43, 95% confidence interval (95% CI) 1.29–1.59). We observed this association irrespective of the type of drug, time of exposure during pregnancy, and maternal history of allergy. The use of maternal acid‐suppressive medication was associated with an increased OR for the development of childhood asthma (3.7% in the population at large vs. 5.6% in exposed children, OR 1.51, 95% CI 1.35–1.69), but not for other allergic diseases. Conclusion These data provide first evidence of a significant association between in utero exposure to acid‐suppressive drugs and the risk of developing childhood asthma.