Prenatal Exposure to Antacids Increases Food Protein-Induced Allergic Proctocolitis Risk

After careful consideration, the American Academy of Allergy, Asthma & Immunology canceled its annual meeting that was to take place in Philadelphia, Pennsylvania from March 13 to 16, because of concerns regarding the coronavirus disease 2019 (COVID-19) outbreak. Although the live events will not proceed as planned, our readers can still find coverage of research that was scheduled to be presented at the meeting.

Prenatal exposure to calcium carbonate antacids was associated with the development of food protein-induced allergic proctocolitis (FPIAP), a type of delayed inflammatory gut food allergy to protein, in offspring. This is according to findings from the Gastrointestinal Microbiome and Allergic Proctocolitis (GMAP) Study intended to be presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI).

In the ongoing, prospective observational GMAP cohort study, a total of 1003 healthy newborn infants were enrolled at the first well visit. At the time of study enrollment and before the development of FPIAP, an initial comprehensive visit questionnaire was administered that queried the mothers on their use of prenatal antacids. An expert clinician’s judgment and the documented presence of gross blood or mucus in the stool were used to determine an FPIAP diagnosis.

Approximately 13% of the 903 infants who were assessed in this analysis were diagnosed with FPIAP. A total of 67 mothers (7%) had reported taking a histamine-2 (H2) receptor antagonist, and 113 mothers (13%) reported taking a calcium carbonate antacid during pregnancy.

The development of FPIAP was significantly associated with prenatal exposure to calcium carbonate antacids (odds ratio [OR], 2.38; 95% CI, 1.47-3.87; P =.0004). No association was found between an FPIAP diagnosis and prenatal exposure to an H2 blocker (OR, 1.66; 95% CI, 95% CI, 0.88-3.14; P =.12). In a multivariable analysis adjusted for sex, race, maternal proton pump inhibitor and H2 blocker use, and relevant family history, the association between prenatal calcium carbonate antacid exposure and FPIAP persisted.

According to the investigators, additional research is needed to further explore this potential association between infant FPIAP and prenatal antacid exposure.

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Marget M, Martin V, Virkud Y, et al. Maternal prenatal use of reflux medication and the development of food protein-induced allergic proctocolitis in offspring. J Allergy Clin Immunol. 2020;145(Suppl 2):AB51.