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Proton pump inhibitors during pregnancy and adverse pregnancy outcomes

van Leeuwen, Lotte (2019) Proton pump inhibitors during pregnancy and adverse pregnancy outcomes. Master's Thesis / Essay, Medical Pharmaceutical Sciences.


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Heartburn is an often-occurring complaint during pregnancy and is often linked to gastroesophageal reflux disease (GERD). Due to its high incidence (30 – 80%) health professionals consider it to be a normal pregnancy symptom. Nevertheless, symptoms can be problematic and treatment is important. First-line drugs for the treatment of GERD are the proton pump inhibitors (PPIs). PPIs are gastric acid suppressing agents, reducing the production of gastric acid by blocking the final step of acid secretion. PPIs are known to be safe in the non- pregnant population. However, the safety in the pregnant population has yet to be established. During this literature research, in utero exposure to the three most common PPIs; omeprazole, esomeprazole, lansoprazole and its adverse pregnancy outcomes; asthma, major congenital malformations, low birthweight in the offspring and maternal pre-eclampsia have been looked into. Due to a lack of studies on the individual safety of PPIs for the outcomes of asthma and pre-eclampsia, subdivision per PPI was not possible. Therefore, the whole group of PPIs is associated with an increased risk on asthma and pre-eclampsia. Omeprazole and lansoprazole were both not associated with increased risks for major congenital malformations or low birthweight. For esomeprazole no information is available on the risk for congenital malformations and low birthweight. For this reason, we cannot exclude that esomeprazole is a possible risk factor for both congenital anomalies and low birthweight, although being the S- enantiomer of the racemate (S-,R-)omeprazole does not make this risk very probable. Due to the extensive research and available data on omeprazole, this PPI was chosen to be the safest choice during pregnancy. For the other PPIs, more studies should be done to investigate their individual properties and safety. In this way, we hope to find more reassurance on the safest option during severe pregnancy-related GERD.

Item Type: Thesis (Master's Thesis / Essay)
Supervisor nameSupervisor E mail
Degree programme: Medical Pharmaceutical Sciences
Thesis type: Master's Thesis / Essay
Language: English
Date Deposited: 07 May 2019
Last Modified: 10 May 2019 10:36

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