TITLE

The Safety of Proton Pump Inhibitors (PPIs) in Pregnancy: A Meta-Analysis

AUTHOR(S)
Gill, Simerpal K.; O'Brien, Lisa; Einarson, Thomas R.; Koren, Gideon
PUB. DATE
June 2009
SOURCE
American Journal of Gastroenterology;Jun2009, Vol. 104 Issue 6, p1541
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES:Heartburn and acid reflux are common medical disorders in pregnancy and can result in serious discomfort and complications. Furthermore, some pregnant women also experience more severe gastrointestinal conditions, such as Helicobacter pylori infections, peptic ulcers, and Zollinger–Ellison syndrome. To allow the use of proton pump inhibitors (PPIs) in pregnancy, the fetal safety of this drug class must be established. The aim of this study is to determine the fetal safety of PPIs during early pregnancy through systematic literature review.METHODS:All original research assessing the safety of PPIs in pregnancy was sought from inception to July 2008. Two independent reviewers identified articles, compared results, and settled differences through consensus. The Downs–Black scale was used to assess quality. Data assessed included congenital malformations, spontaneous abortions, and preterm delivery. A random effects meta-analysis combined the results from included studies.RESULTS:Of the 60 articles identified, 7 met our inclusion criteria. Using data from 134,940 patients, including 1,530 exposed and 133,410 not exposed to PPIs, the overall odds ratio (OR) for major malformations was 1.12 (95% confidence interval, CI: 0.86–1.45). Further analysis revealed no increased risk for spontaneous abortions (OR=1.29, 95% CI: 0.84–1.97); similarly, there was no increased risk for preterm delivery (OR=1.13, 95% CI: 0.96–1.33). In the secondary analysis of 1,341 exposed and 120,137 not exposed to omeprazole alone, the OR and 95% CI for major malformations were 1.17 and 0.90–1.53, respectively.CONCLUSIONS:On the basis of these results, PPIs are not associated with an increased risk for major congenital birth defects, spontaneous abortions, or preterm delivery. The narrow range of 95% CIs is further reassuring, suggesting that PPIs can be safely used in pregnancy.Am J Gastroenterol 2009; 104:1541–1545; doi:10.1038/ajg.2009.122; published online 28 April 2009
ACCESSION #
40737267

 

Related Articles

  • Continuing Medical Education Questions: June 2009. Scolapio, James S.; Hasan, Muhammad K.; Buchner, Anna M.; Gill, Kanwar R. S. // American Journal of Gastroenterology;Jun2009, Vol. 104 Issue 6, p1546 

    The article presents questions to the readers of the journal with reference to the article "The Safety of Proton Pump Inhibitors (PPIs) in Pregnancy: A Meta-Analysis," published in a previous issue of the journal. Some of the questions included are: which outcome was included in this...

  • What medications are safe and effective for heartburn during pregnancy? Koenig, Clint J.; Marquardt, Donald N. // Journal of Family Practice;Apr2001, Vol. 50 Issue 4, p304 

    The article answers a query on which medications are safe and effective for heartburn during pregnancy. The best-studied agent for treatment of heartburn in pregnancy is ranitidine. Metoclopromide, proton pump inhibitors, and sucralfate are probably safe in pregnancy, but there are no data about...

  • Effects of Proton Pump Inhibitors on Adverse Gastrointestinal Events in Patients Receiving Clopidogrel. Chun Shing Kwok; Ramanpreet Singh Nijjar; Yoon Kong Loke // Drug Safety;2011, Vol. 34 Issue 1, p47 

    Background: There has been recent concern regarding a possible adverse interaction between clopidogrel and proton pump inhibitors (PPIs), coupled with uncertainty as to whether PPIs genuinely help in reducing gastrointestinal (GI) harm. Objective: To perform a meta-analysis of GI outcomes in...

  • GASTROINTESTINAL TRACT.  // Monthly Prescribing Reference;Dec2011, Vol. 27 Issue 12, p177 

    The article offers information on drugs prescribed for gastrointestinal tract disorders. Among the adverse effects linked with the proton pump inhibitor Aciphex from Janssen are headache, constipation and flatulence. Contraindications of anticholinergic Bentyl from Axcan Pharma are glaucoma,...

  • Proton pump inhibitors safe to use in pregnancy.  // Reactions Weekly;8/8/2009, Issue 1264, p4 

    The article discusses research being done on proton pump inhibitors. It references the study "The Safety of Proton Pump Inhibitors (PPIs) in Pregnancy: A Meta-Analysis," by S. K. Gill et al in the June 2009 issue of the "American Journal of Gastroenterology." The research aims to determine the...

  • Prevention of gastrointestinal bleeding due to stress ulceration: a review of current literature. Pilkington, K. B.; Wagstaff, M. J. D.; Greenwood, J. E. // Anaesthesia & Intensive Care;Mar2012, Vol. 40 Issue 2, p253 

    The article discusses a review of randomised controlled trials and meta-analyses on the prevention of upper gastrointestinal bleeding (UGIB) caused by stress ulceration. The authors present a comparison of proton pump inhibitors (PPI) and histamine-2 receptor antagonists (H2RA) in the prevention...

  • PPI versus Histamine H2 Receptor Antagonists for Prevention of Upper Gastrointestinal Injury Associated with Low-Dose Aspirin: Systematic Review and Meta-analysis. Mo, Chen; Sun, Gang; Wang, Yan-Zhi; Lu, Ming-Liang; Yang, Yun-Sheng // PLoS ONE;7/6/2015, Vol. 10 Issue 7, p1 

    This study compared proton pump inhibitors (PPIs) and histamine H2 receptor antagonists (H2RAs) for prevention of low-dose aspirin (LDA)-related gastrointestinal (GI) erosion, ulcer and bleeding. Electronic databases including PubMed, Embase, Cochrane Central Register of Controlled Trials,...

  • Second opinion.  // Mayo Clinic Health Letter;APr2015, Vol. 33 Issue 4, p8 

    The article provides an answer to the question of whether there are any risks in taking a proton pump inhibitor.

  • Does Long-Term Proton Pump Inhibitor Therapy Affect the Health of Gut Microbiota? Chansu Lee; Sung Noh Hong // Gut & Liver;Nov2016, Vol. 10 Issue 6, p865 

    An introduction is presented in which the editor discusses various reports within the issue on topics including proton pump inhibitor therapy, its effects on the human gut microbiota and its side effects on patients of bariatric surgery.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics