Associations between late-onset preeclampsia and the use of
calcium-based antacids and proton pump inhibitors during pregnancy: a
prospective cohort study
Abstract
Objective: To determine associations of calcium-based antacid and PPI
use during pregnancy with late-onset preeclampsia (≥34 weeks of
gestation), taking into account dosage and timing of use. Design:
Prospective cohort study. Setting: This study used data from the PRIDE
Study (2012-2019) and Dutch Pregnancy Drug Register (2014-2019). Sample:
A total of 9,058 pregnant Dutch women aged ≥18 years. Methods: Data were
collected through web-based questionnaires and obstetric records. We
estimated risk ratios (RRs) for late-onset preeclampsia for any use and
trajectories of calcium-based antacid and PPI use before gestational day
238, and hazard ratios for time-varying exposures after gestational day
237. Main outcome measure: Late-onset preeclampsia. Results: Late-onset
preeclampsia was diagnosed in 2.6% of pregnancies. Any use of
calcium-based antacids (RR 1.2 [95% CI 0.9-1.6]) or PPIs (RR 1.4
[95% CI 0.8-2.4]) before gestational day 238 was not associated
with late-onset preeclampsia. Use of low-dose calcium-based antacids in
gestational weeks 0-16 (<1g/day; RR 1.8 [95% CI 1.1-2.9])
and any use of PPIs in gestational weeks 17-33 (RR 1.6 [95% CI
1.0-2.8]) seemed to increase risks of late-onset preeclampsia. We did
not observe associations between late-onset preeclampsia and use of
calcium-based antacids and PPIs after gestational day 237. Conclusions:
In this prospective cohort study, use of calcium-based antacids and PPIs
during pregnancy was not found to reduce the risk of late-onset
preeclampsia. Funding: Netherlands Organisation for Health Research and
Development [ZonMw; grant number 848018010].