Antibiotic, Heartburn Drug Use During Pregnancy and Infancy May Increase Risk of Digestive Problems: Study

Researchers found a dose-response relationship between the amount of antibiotics and acid suppressants used during pregnancy, as well as early childhood, and an increased risk of eosinophilic esophagitis.

Side effects of antibiotics and a popular class of heartburn medication, including drugs like Nexium Prilosec and Prevacid, during pregnancy or early infancy may increase the risk of developing a serious type of digestive problem, according to the findings of a new study.

Infants and mothers who took antibiotics and heartburn drugs faced an increased risk of suffering from eosinophilic esophagitis, according to findings published this week in the medical journal JAMA Pediatrics.

Eosinophilic esophagitis involves an inflammation of the esophagus, which is the tube connecting the mouth to the stomach. The digestive problem can be caused by an allergic reaction from a food allergy, airborne allergy, or acid reflux, resulting when the immune system overreacts, and white blood cells rush to the area.

Antibiotic and Acid Suppressant Risks During Pregnancy and Infancy

Researchers from the Wake Forest University School of Medicine, Aarhus University in Denmark, and UNC-Chapel Hill, North Carolina, conducted a population-based case-control study involving nearly 400 patients and 3,600 control cases in Denmark from 1997 to 2018. They used pathology, prescriptions, birth records, as well as inpatient and outpatient health registry data.

According to the findings, maternal and infant use of antibiotics was linked with an increased risk of developing eosinophilic esophagitis. The risk of eosinophilic esophagitis was also increased for mothers and children who took acid suppressants, commonly called antacids, such as Prilosec and Nexium.

The findings indicate children who took antibiotics when they were infants experienced an increased risk of eosinophilic esophagitis by 40% compared with children who took no antibiotics during infancy. The risk was heightened if the child was six months old or younger.

In addition, any use of antacids during pregnancy increased a child’s risk of having eosinophilic esophagitis, according to the findings. This held true when researchers looked at data only for children diagnosed before the age of five years old.

Pregnant mothers who used antibiotics during pregnancy also experienced an increased risk of suffering from the condition, especially if they were in their third trimester of pregnancy. The more antibiotics they took, the higher the risk.

Dose Response Relationship Seen

The researchers determined eosinophilic esophagitis occurred in a dose-response manner, meaning the more a patient used antibiotics or antacids, the greater they suffered from the condition. This was especially true for pregnant women in the third trimester or closer to the third trimester. This is usually considered a strong indicator of a causal relationship.

“Maternal and infant antibiotic use was associated with increased risk of developing eosinophilic esophagitis, in a dose-response manner,” the researchers concluded. “Increased risk was also observed with maternal and infant acid suppressant use. Exposure during early life, a period of known developmental susceptibility, may confer the greatest risk and opportunity for risk mitigation.”

The researchers warn it is important for the medical community and patients to focus on the risk factors that may lead to disease development to help reduce the need for these drugs.