CONTEXT: The association between acid-suppressive drug exposure during pregnancy and childhood asthma has not been well established. OBJECTIVE: To conduct a systematic review and meta-analysis on this association to provide further justification for the current studies. DATA SOURCES: We searched PubMed, Medline, Embase, the Cochrane Database of Systematic Reviews, EBSCO Information Services, Web of Science, and Google Scholar from inception until June 2017. STUDY SELECTION: Observational studies in which researchers assessed acid-suppressive drug use during pregnancy and the risk of childhood asthma were included. DATA EXTRACTION: Of 556 screened articles, 8 population-based studies were included in the final analyses. RESULTS: When all the studies were pooled, acid-suppressive drug use in pregnancy was associated with an increased risk of asthma in childhood (relative risk [RR] = 1.45; 95% confidence interval [CI] 1.35a??1.56; I2 = 0%; P .00001). The overall risk of asthma in childhood increased among proton pump inhibitor users (RR = 1.34; 95% CI 1.18a??1.52; I2 = 46%; P .00001) and histamine-2 receptor antagonist users (RR = 1.57; 95% CI 1.46a??1.69; I2 = 0%; P .00001). LIMITATIONS: None of the researchers in the studies in this meta-analysis adjusted for the full panel of known confounders in these associations. CONCLUSIONS: The evidence suggests that prenatal, maternal, acid-suppressive drug use is associated with an increased risk of childhood asthma. This information may help clinicians and parents to use caution when deciding whether to take acid-suppressing drugs during pregnancy because of the risk of asthma in offspring.
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机译：背景：怀孕期间酸抑制药物暴露与儿童哮喘之间的关系尚未建立。目的：对该协会进行系统的综述和荟萃分析，为当前研究提供进一步的依据。数据来源：从开始到2017年6月，我们搜索了PubMed，Medline，Embase，Cochrane系统评价数据库，EBSCO信息服务，Web of Science和Google Scholar。研究选择：观察性研究，研究人员在研究过程中评估了抑酸药物的使用包括妊娠和儿童哮喘的风险。数据提取：在556篇筛选的文章中，8项基于人群的研究纳入了最终分析。结果：当所有研究汇总后，妊娠期使用酸抑制药物与儿童哮喘风险增加相关（相对风险[RR] = 1.45; 95％置信区间[CI] 1.35a ?? 1.56; I2 = 0％; P <.00001）。质子泵抑制剂使用者（RR = 1.34; 95％CI 1.18a ?? 1.52; I2 = 46％; P <.00001）和组胺2受体拮抗剂使用者（儿童组）儿童期哮喘的总体风险增加（RR = 1.57; 95） ％CI1.46a≤1.69; I2 ＝ 0％; P ＜.00001）。局限性：在这项荟萃分析中，没有研究人员针对这些协会中的已知混杂因素进行全面调整。结论：有证据表明，产前，产妇，酸抑制药物的使用与儿童哮喘风险增加有关。该信息可能有助于临床医生和父母在决定是否在怀孕期间服用抑酸药物时要谨慎，因为其后代有哮喘风险。
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