(212) Associations Between Late-Onset Preeclampsia and The Use of Calcium-Based Antacids and Proton Pump Inhibitors During Pregnancy: A Prospective Cohort Study

Publication Number: 543

Background: Preeclampsia is one of the leading causes of maternal morbidity and mortality. Calcium-based antacids and proton pump inhibitors (PPIs) are commonly used during pregnancy to treat symptoms of gastroesophageal reflux disease. Both have been hypothesized to reduce the risk of preeclampsia.

Objectives: To determine the associations of calcium-based antacid and PPI use during pregnancy with late-onset preeclampsia, taking into account dosage and timing of use.

Methods: We included 9,058 pregnant women participating in the PRIDE Study (2012-2019) or pREGnant (2014-2019), two prospective cohorts in The Netherlands. 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, as well as hazard ratios for time-varying exposures after gestational day 237. The models were weighted using inverse probability of censoring weights and adjusted for a sufficient set of confounders.

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. However, 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 the risk of late-onset preeclampsia. We did not observe any 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.