Key result
There is insufficient evidence to draw conclusions on the overall effectiveness and safety of interventions to relieve heartburn in pregnancy, as the three included trials examined different medications and could not be pooled.
Why the study?
Do interventions such as prostigmine, antacids, or ranitidine relieve heartburn in pregnant women?
Systematic Review (n=286)
Do interventions such as prostigmine, antacids, or ranitidine relieve heartburn in pregnant women?
There is limited evidence from small trials suggesting that prostigmine, antacids, and ranitidine may relieve heartburn in pregnancy, but overall effectiveness remains unestablished.
Insufficient evidence advises against changing practice for pregnancy heartburn; leaves open need for comparable trials to assess interventions.
BACKGROUND: Heartburn is a common symptom in pregnancy affecting up to 80% of women in the third trimester. The reasons for the increase in symptoms in pregnancy are not well understood, but the effects of pregnancy hormones on the lower oesophageal sphincter and gastric clearance are thought to play a part. A range of interventions have been used to relieve symptoms including advice on diet and lifestyle, antacids, antihistamines, and proton pump inhibitors. The safety and effectiveness of these interventions to relieve heartburn in pregnancy have not been established. OBJECTIVES: To assess the effect of interventions to relieve heartburn in pregnancy. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2008). SELECTION CRITERIA: We included randomised controlled trials evaluating interventions to relieve heartburn. DATA COLLECTION AND ANALYSIS: We assessed eligibility for inclusion and extracted data independently. MAIN RESULTS: Three studies were eligible for inclusion, together they included a total of 286 women. All three were placebo controlled trials, each examining a different medication to relieve heartburn (intramuscular prostigmine, an antacid preparation and an antacid plus ranitidine). All three produced positive findings in favour of the intervention groups. It was not possible to pool findings from studies to produce an overall treatment effect. AUTHORS' CONCLUSIONS: There was little information to draw conclusions on the overall effectiveness of interventions to relieve heartburn in pregnancy.
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A 2008 study conducted a systematic review in Heartburn in pregnancy (n=286). Pharmacological interventions (prostigmine, antacids, ranitidine) vs. Placebo or active control was evaluated on Relief from heartburn. There is insufficient evidence to draw conclusions on the overall effectiveness and safety of interventions to relieve heartburn in pregnancy, as the three included trials examined different medications and could not be pooled.
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