- Proton pump inhibitors (PPIs) may be associated with a slightly increased risk for congenital anomalies but decreased risk for spontaneous abortion.
Why this matters
- PPIs are commonly used during pregnancy despite conflicting data on their safety.
- PPIs have been associated with childhood asthma in offspring and increased risk for cholestasis.
- PPIs should be used during pregnancy only when the benefits outweigh the risks.
- 23 studies reported on congenital malformations.
- The overall risk for congenital malformations was higher in women using PPIs:
- OR, 1.28 (95% CI, 1.09-1.52).
- No significant increased risk seen for hypospadias, cleft palate without cleft lip, cardiovascular malformations, club foot, stillbirth, or preterm birth.
- 3 studies reported on spontaneous abortion, showing a decreased risk in PPI users:
- OR, 0.66 (95% CI, 0.43-1.00).
- Systematic literature review and meta-analysis (26 studies).
- Exposure was defined as any type of PPI used during pregnancy.
- Exposed group was compared with a control group from the same study population.
- Funding: None disclosed.
- Limitations related to limitations of original studies.
- Heterogeneity among studies.