Key result
Calcium-based antacids and PPIs during pregnancy show no link to reduced late-onset preeclampsia risk.
Why the study?
Calcium-based antacids and proton pump inhibitors are commonly used during pregnancy and hypothesized to reduce preeclampsia risk, but associations with late-onset preeclampsia remained unclear.
Does the use of calcium-based antacids and proton pump inhibitors during pregnancy reduce the risk of late-onset preeclampsia in pregnant women?
Cohort (n=9,058)
Yes
Does the use of calcium-based antacids and proton pump inhibitors during pregnancy reduce the risk of late-onset preeclampsia in pregnant women?
Effect estimate: RR 1.2 (95% CI 0.9-1.6)
The use of calcium-based antacids and proton pump inhibitors during pregnancy does not reduce the risk of late-onset preeclampsia.
No association with reduced late-onset preeclampsia risk; does not support preventive use and leaves causal effects open.
Purpose: Preeclampsia is a leading cause of maternal morbidity and mortality. Calcium-based antacids and proton pump inhibitors (PPIs) are commonly used during pregnancy to treat symptoms of gastroesophageal reflux disease. Both have been hypothesized to reduce the risk of preeclampsia. We determined associations of calcium-based antacid and PPI use during pregnancy with late-onset preeclampsia (≥34 weeks of gestation), taking into account dosage and timing of use. Patients and Methods: We included 9058 pregnant women participating in the PRIDE Study (2012-2019) or The Dutch Pregnancy Drug Register (2014-2019), two prospective cohorts in The Netherlands. Data were collected through web-based questionnaires and obstetric records. We estimated risk ratios (RRs) for late-onset preeclampsia for any use and trajectories of calcium-based antacid and PPI use before gestational day 238, and hazard ratios (HRs) for time-varying exposures after gestational day 237. Results: Late-onset preeclampsia was diagnosed in 2.6% of pregnancies. Any use of calcium-based antacids (RR 1.2 [95% CI 0.9-1.6]) or PPIs (RR 1.4 [95% CI 0.8-2.4]) before gestational day 238 was not associated with late-onset preeclampsia. Use of low-dose calcium-based antacids in gestational weeks 0-16 (<1 g/day; RR 1.8 [95% CI 1.1-2.9]) and any use of PPIs in gestational weeks 17-33 (RR 1.6 [95% CI 1.0-2.8]) seemed to increase risks of late-onset preeclampsia. We did not observe associations between late-onset preeclampsia and use of calcium-based antacids (HR 1.0 [95% CI 0.6-1.5]) and PPIs (HR 1.4 [95% CI 0.7-2.9]) after gestational day 237. Conclusion: In this prospective cohort study, use of calcium-based antacids and PPIs during pregnancy was not found to reduce the risk of late-onset preeclampsia.
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Gelder et al. (2022) conducted a cohort in Late-onset preeclampsia (n=9,058). Calcium-based antacids and proton pump inhibitors vs. Non-use was evaluated on Late-onset preeclampsia (≥34 weeks of gestation) (RR 1.2, 95% CI 0.9-1.6). Use of calcium-based antacids (RR 1.2; 95% CI 0.9-1.6) or PPIs (RR 1.4; 95% CI 0.8-2.4) during pregnancy was not associated with a reduced risk of late-onset preeclampsia.
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