No link between prenatal exposure to acid suppressants and neuropsychiatric disorders in offspring

Exposure to acid-suppressive medications during pregnancy does not appear to contribute to the risk of neuropsychiatric disorders in children, according to a retrospective study.

Researchers used data from the South Korean National Health Insurance Service database and identified 2,777,119 mother–child pairs. Of these, 507 845 pairs had prenatal exposure to a proton pump inhibitor or histamine 2 receptor antagonist (exposed group) and were followed up for a mean of 10.3 years.

Analyses were conducted using a propensity score–based overlap-weighted cohort (403,658 mother–child pairs in the exposed group and 403,659 pairs in the unexposed group) and a sibling-matched cohort (157,069 exposed offspring and 164,669 unexposed offspring). Offspring neuropsychiatric disorders included attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASD), intellectual disability, severe neuropsychiatric disorder, and obsessive-compulsive disorder.

In the overlap-weighted cohort, the exposed and unexposed groups had similar proportions of offspring who had ADHD (4.85 percent vs 4.25 percent), ASD (1.45 percent vs 1.33 percent), intellectual disability (1.25 percent vs 1.09 percent), severe neuropsychiatric disorder (0.94 percent vs 0.81 percent), or obsessive-compulsive disorder (0.3 percent vs 0.27 percent).

The adjusted hazard ratio (HR) with prenatal acid-suppressive medication exposure vs nonexposure was 1.14 (95 percent confidence interval [CI], 1.12–1.17) for ADHD, 1.07 (95 percent CI, 1.03–1.11) for ASD, 1.13 (95 percent CI, 1.09–1.18) for intellectual disability, 1.16 (95 percent CI, 1.10–1.21) for severe neuropsychiatric disorder, and 1.12 (95 percent CI, 1.03–1.21) for obsessive-compulsive disorder.

Sibling-control analyses showed no significant associations between prenatal exposure to acid suppressants and offspring outcomes. The adjusted HRs were 0.98 (95 percent CI, 0.95–1.02) for ADHD, 0.98 (95 percent CI, 0.92–1.04) for ASD, 1.02 (95 percent CI, 0.95–1.09) for intellectual disability, 1 (95 percent CI, 0.93–1.08) for severe neuropsychiatric disorder, and 0.95 (95 percent CI, 0.82–1.10) for obsessive-compulsive disorders.