Acid-suppression in pregnancy and allergy in children

Acid reflux symptoms are common in pregnancy, and women are often reassured by professionals that taking medicines for acid-suppression cannot harm their unborn child. But is this justified? We know that the immunological foundation for allergy is set in pregnancy, and some of these drugs may have an effect on the developing fetal immune system. Researchers from Groningen, Netherlands, used the comprehensive Dutch prescription records to study this (Mulder and colleagues. Clin Exp Allergy 2014;44:261–9). For over 35 000 children from 22 800 mothers, they were able to link maternal prescriptions for Histamine 2-antagonists (H2As) and proton pump inhibitors (PPIs) at each trimester of pregnancy with prescriptions for allergic disease in their children: ≥2 prescriptions over a 12-month period for atopic dermatitis, nasal or inhaled steroids (over age 5). In children whose mothers took H2As or PPIs they found …