Prenatal exposure to acid-suppressive medications (ASMs) seems not to be associated with allergic diseases in offspring, according to a study published online Jan. 9 in JAMA Pediatrics.

Yunha Noh, Pharm.D., Ph.D., from the School of Pharmacy at Sungkyunkwan University in Suwon, South Korea, and colleagues examined the association between prenatal or infant exposure to ASMs and the risk for allergic diseases in children in a nationwide cohort study. Participants included 4,149,257 mother-child pairs of neonates born from April 1, 2008, to Dec. 31, 2019.

The researchers found that in prenatal exposure analyses with 808,067 propensity score-matched pairs, the propensity score-matched hazard ratio (95 percent confidence interval) was 1.01 (1.01 to 1.02) for allergic diseases overall and 1.02 (1.01 to 1.03), 1.02 (1.01 to 1.02), 1.02 (1.01 to 1.02), and 1.03 (0.97 to 1.03), respectively, for asthma, allergic rhinitis, atopic dermatitis, and food allergy. The hazard ratios were similar but not significant in sibling-matched analyses (allergic diseases: hazard ratio, 1.01; 95 percent confidence interval, 0.997 to 1.01).

In infant exposure analyses with 84,263 propensity score-matched pairs, the propensity score-matched hazard ratio (95 percent confidence interval) was 1.06 (1.05 to 1.07) for allergic diseases overall and 1.16 (1.14 to 1.18), 1.02 (1.01 to 1.03), 1.05 (1.02 to 1.08), and 1.28 (1.10 to 1.49), respectively, for asthma, allergic rhinitis, atopic dermatitis, and food allergy. In sibling-matched analyses, asthma risk remained significantly higher among children exposed to ASMs during infancy (hazard ratio, 1.13; 95 percent confidence interval, 1.09 to 1.17).

“Clinicians should therefore carefully weigh the benefits of prescribing ASMs to children against its small but potential risk of asthma,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

More information:
Yunha Noh et al, Prenatal and Infant Exposure to Acid-Suppressive Medications and Risk of Allergic Diseases in Children, JAMA Pediatrics (2023). DOI: 10.1001/jamapediatrics.2022.5193

Journal information:
JAMA Pediatrics

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