Featured Research

from universities, journals, and other organizations

Proton-pump inhibitors and birth defects: Some reassurances, but more needed, warns epidemiologist

Date:
November 26, 2010
Source:
Boston University Medical Center
Summary:
Despite the reassurances about the use of proton-pump inhibitors during pregnancy based on a new study, an epidemiologist believes that further studies are needed.

Despite the reassurances of Pasternak and Hviid in their study, "Use of Proton-Pump Inhibitors (PPI) in Early Pregnancy and the Risk of Birth Defects," featured in the Nov. 24 issue of the New England Journal of Medicine, an epidemiologist from Boston University School of Medicine (BUSM) believes that further studies are needed.

The original study found that on the basis of data from more than 840,000 live births in Denmark, there was no evidence to suggest that the use of the most common PPIs (omeprazole, lansoprazole, and esomeprazole) anytime during pregnancy increased the risk of birth defects overall, and in the case of omeprazole, the PPI used most commonly during pregnancy, they found no evidence of a risk among selected subgroups of major birth defects. "These findings, together with earlier reports that were based on smaller numbers of pregnant women exposed to PPIs, are important in providing some reassurance about the safety of these drugs when they are taken during pregnancy," said editorial author Allen A. Mitchell, MD, director of BUSM's Slone Epidemiology Center. "However, as the authors acknowledge, these data provide only a broad -- and incomplete -- overview," he added.

According to Mitchell, drugs that cause birth defects, called teratogens, tend to increase the risks of specific birth defects, not birth defects overall. Secondly, although medications in the same class (e.g., PPIs) share pharmacologic effects, they may have very different effects on the fetus. Of particular importance, Mitchell points out that despite the large size of this study population, "it was still too small to consider the risks of specific birth defects in relation to specific PPIs, which is what we need to know." One finding of possible concern is that women who took PPIs in the weeks just before pregnancy -- but not during pregnancy -- seemed to have an increased risk of birth defects, and this observation needs to be understood; the one PPI that did not show any increased risk during these weeks before pregnancy was omeprazole.

Lastly, despite the richness of the data sources used for the Danish study, Mitchell notes that they lack information on important variables that could themselves account for possible associations between medications and birth defects, including the reasons for the use of PPIs. They also lack information on exposures to over-the-counter medications; among this latter group, for example, it is critical to know whether women were taking folic-acid around the time of conception, since folic acid has been repeatedly shown to reduce the risk of a number of birth defects.

Mitchell points out that the report by Pasternak and Hviid represents the best available data on the possible risk of birth defects associated with the use of PPIs during pregnancy, and it supports two conclusions. First, the PPIs most commonly represented in the study do not appear to carry major risks of birth defects when they are taken during the first trimester or later in pregnancy. Second, the modestly increased risk during the period before conception that was observed with PPIs as a group was not seen with omeprazole.

Further studies using a case-control design are needed to consider specific defects in relation to individual PPIs, and future analyses must also include information on critical additional variables, such as use of folic acid supplements around the time of conception. "Until such studies are available, the current findings, although reassuring, must be considered far from definitive," stressed Mitchell.


Story Source:

The above story is based on materials provided by Boston University Medical Center. Note: Materials may be edited for content and length.


Journal References:

  1. Björn Pasternak, Anders Hviid. Use of Proton-Pump Inhibitors in Early Pregnancy and the Risk of Birth Defects. New England Journal of Medicine, 2010; 363 (22): 2114 DOI: 10.1056/NEJMoa1002689
  2. Allen A. Mitchell. Proton-Pump Inhibitors and Birth Defects — Some Reassurance, but More Needed. New England Journal of Medicine, 2010; 363 (22): 2161 DOI: 10.1056/NEJMe1009631

Cite This Page:

Boston University Medical Center. "Proton-pump inhibitors and birth defects: Some reassurances, but more needed, warns epidemiologist." ScienceDaily. ScienceDaily, 26 November 2010. <www.sciencedaily.com/releases/2010/11/101124171530.htm>.
Boston University Medical Center. (2010, November 26). Proton-pump inhibitors and birth defects: Some reassurances, but more needed, warns epidemiologist. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2010/11/101124171530.htm
Boston University Medical Center. "Proton-pump inhibitors and birth defects: Some reassurances, but more needed, warns epidemiologist." ScienceDaily. www.sciencedaily.com/releases/2010/11/101124171530.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) — The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) — Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com
Condemned Man's US Execution Takes Nearly Two Hours

Condemned Man's US Execution Takes Nearly Two Hours

AFP (July 24, 2014) — America's death penalty debate raged Thursday after it took nearly two hours for Arizona to execute a prisoner who lost a Supreme Court battle challenging the experimental lethal drug cocktail. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
Can Watching TV Make You Feel Like A Failure?

Can Watching TV Make You Feel Like A Failure?

Newsy (July 24, 2014) — A study by German researchers claims watching TV while you're stressed out can make you feel guilty and like a failure. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:  

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile iPhone Android Web
          Follow Facebook Twitter Google+
          Subscribe RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins