Exploration of Proton Pump Inhibitors Use During Pregnancy and Preeclampsia

Abstract

This cohort study examines whether proton pump inhibitor use during pregnancy is associated with the rate of preeclampsia.

Figure.. Risk of All Preeclampsia and Preterm Preeclampsia Following Maternal Exposure to PPIs and Dose-Response Relationship Between the Use of PPIs and Risk of All and Preterm Preeclampsia

Abbreviations: cDDD, cumulative defined daily dose; H2RA, histamine 2 receptor antagonist; PPI, proton pump inhibitor; RR, relative risk. ^aAdjusted for age and insurance type at delivery, nulliparity, multiple gestation, Charlson comorbidity index, indications for acid suppressive medications, including gastroesophageal reflux disease, heartburn, ulcer (eg, gastric, duodenal, peptic, and gastrojejunal ulcers and Zollinger-Ellison syndrome), maternal medical conditions (eg, asthma, anxiety, diabetes, depression, and chronic hypertension), inflammatory diseases (inflammatory bowel disease, systemic lupus erythematosus, rheumatoid arthritis), migraine/headache, renal disease, thyroid disorder, concurrent medications (eg, antidepressants, antiepileptics, antipsychotics, antihypertensives, antithrombotic agents, benzodiazepines, corticosteroids, oral hypoglycemics, insulin, nonsteroidal anti-inflammatory drugs, opioid analgesics, and disease-modifying antirheumatic drugs), and proxies of health care utilization (eg, the number of outpatient visits and hospitalizations). The proxies of health care utilization were assessed during a period of 180 days before the start of pregnancy, and other covariates were measured during the period of 180 days before the start of pregnancy to week 20 of the gestational period. ^bcDDD is calculated as the sum of DDD prescribed during pregnancy.