More than half of all pregnant women suffer from gastroesophageal reflux, (GERD), more commonly known as acid reflux or heartburn, and can be difficult to manage during pregnancy. The symptoms often start early in pregnancy - precisely when the fetus is most vulnerable to the effects of medications which may cause birth defects. According to a recent study from the University of Pennsylvania School of Medicine, pregnant women who use proton pump inhibitor (PPI) medications to treat GERD may have an increased risk of newborn cardiac birth defects.
Of all the PPIs researchers looked at, omeprazole was associated with the greatest increase in risk for having a baby with a cardiac birth defect. Due to the prevalence of GERD during pregnancy and the popularity of this class of anti-reflux medications, the investigators sought to determine the drugs' safety and found that PPI use during pregnancy was associated with a doubling in the risk of cardiac newborn cardiac birth defects such as ventricular septal defect. Physicians usually try to first treat pregnancy-related GERD conservatively through diet and behavior modification. These methods are often ineffective, causing physicians to increasingly prescribe PPIs which are extremely effective in treating GERD by partially stopping the production of acid in the stomach. However, PPIs are relatively new to the market and not much has been known about their long-term use or safety during pregnancy since there have been no adequate or large enough human studies before now.
Penn researchers stress that patients and physicians need to weigh the benefits and possible risks of PPIs on a case-by-case basis since heartburn during pregnancy can be severe and result in poor quality of life. They also suggest that H2 receptor antagonists anti-reflux medications be considered first during pregnancy to minimize potential risks.
