Use of acid-suppressive drugs in pregnancy and the risk of childhood asthma: bidirectional crossover study using the general practice research database. Hak, E., Mulder, B., Schuiling-Veninga, C. C. M., de Vries, T. W., & Jick, S. S. Drug Safety, 36(11):1097--1104, November, 2013.
doi  abstract   bibtex   
BACKGROUND: Recent studies have reported an association between maternal use of gastric acid-suppressive drugs during pregnancy and asthma in the offspring, but the association could have been confounded by unmeasured risk factors. OBJECTIVE: We assessed the association between the use of acid-suppressive drugs during pregnancy and the risk of developing childhood asthma using a bidirectional crossover design. METHODS: Mother-infant matched sets in the UK General Practitioners Research Database were used to identify children with a drug-treated asthma diagnosis during the years 2006-2010 who were matched to a sibling without asthma as controls. Primary exposure was use of any anti-suppressive drug during pregnancy, and subgroup analyses were conducted according to drug class (e.g. proton pump inhibitors or histamine 2 receptor antagonists) and trimester. Conditional logistic regression was used to estimate odds ratios (OR) with their corresponding 95 % confidence intervals (CIs). RESULTS: A total of 1,874 children with asthma and 1,874 control siblings were included in the analysis. The exposure rate among case and control pregnancies was 22 and 20 %, respectively. After adjustments for gender, birth order, mother's age and general practice visits, the exposure to any gastric-acid suppressive drug during pregnancy slightly increased the risk for developing asthma (OR 1.23, 95 % CI 1.01-1.51; p = 0.042). A trend towards increased risks was observed for those who used proton pump inhibitors and/or histamine 2 receptor antagonists (adjusted OR 1.72, 95 % CI 1.00-2.98; p = 0.048). CONCLUSIONS: These findings lend support to the emerging evidence that exposure to acid-suppressive drugs during pregnancy is associated with childhood asthma. More basic research is now warranted to investigate the mechanisms.
@article{hak_use_2013,
	title = {Use of acid-suppressive drugs in pregnancy and the risk of childhood asthma: bidirectional crossover study using the general practice research database},
	volume = {36},
	issn = {0114-5916},
	shorttitle = {Use of acid-suppressive drugs in pregnancy and the risk of childhood asthma},
	doi = {10.1007/s40264-013-0093-z},
	abstract = {BACKGROUND: Recent studies have reported an association between maternal use of gastric acid-suppressive drugs during pregnancy and asthma in the offspring, but the association could have been confounded by unmeasured risk factors.
OBJECTIVE: We assessed the association between the use of acid-suppressive drugs during pregnancy and the risk of developing childhood asthma using a bidirectional crossover design.
METHODS: Mother-infant matched sets in the UK General Practitioners Research Database were used to identify children with a drug-treated asthma diagnosis during the years 2006-2010 who were matched to a sibling without asthma as controls. Primary exposure was use of any anti-suppressive drug during pregnancy, and subgroup analyses were conducted according to drug class (e.g. proton pump inhibitors or histamine 2 receptor antagonists) and trimester. Conditional logistic regression was used to estimate odds ratios (OR) with their corresponding 95 \% confidence intervals (CIs).
RESULTS: A total of 1,874 children with asthma and 1,874 control siblings were included in the analysis. The exposure rate among case and control pregnancies was 22 and 20 \%, respectively. After adjustments for gender, birth order, mother's age and general practice visits, the exposure to any gastric-acid suppressive drug during pregnancy slightly increased the risk for developing asthma (OR 1.23, 95 \% CI 1.01-1.51; p = 0.042). A trend towards increased risks was observed for those who used proton pump inhibitors and/or histamine 2 receptor antagonists (adjusted OR 1.72, 95 \% CI 1.00-2.98; p = 0.048).
CONCLUSIONS: These findings lend support to the emerging evidence that exposure to acid-suppressive drugs during pregnancy is associated with childhood asthma. More basic research is now warranted to investigate the mechanisms.},
	language = {eng},
	number = {11},
	journal = {Drug Safety},
	author = {Hak, Eelko and Mulder, Bianca and Schuiling-Veninga, Catharina C. M. and de Vries, Tjalling W. and Jick, Susan S.},
	month = nov,
	year = {2013},
	pmid = {24018582},
	pmcid = {PMC3824882},
	keywords = {Adult, Antacids, Asthma, Child, Preschool, Confidence Intervals, Cross-Over Studies, Databases, Factual, Female, General Practice, Great Britain, Humans, Logistic Models, Male, Odds Ratio, Prenatal Exposure Delayed Effects, pregnancy},
	pages = {1097--1104}
}

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