EoE Module 1 References-Jensen et al JAMA Pediatr 2023 Maternal and infant antibiotic and acid suppresant use and risk of EoE

Jensen et al JAMA Pediatr 2023 Maternal and infant antibiotic and acid suppresant use and risk of EoE

Pdf Summary

This study explores whether maternal and infant use of antibiotics and acid suppressants are linked to an increased risk of Eosinophilic Esophagitis (EoE) in children. EoE is a chronic inflammatory disease of the esophagus that has become more common globally. The researchers conducted a population-based case-control study in Denmark, analyzing data from varied health registries to include 392 pediatric EoE cases and 3637 matched controls born between 1997 and 2018.<br /><br />Key findings include:<br /><br />1. **Antibiotic Use**:<br />   - **Infant Antibiotic Use**: Infants exposed to antibiotics had a 40% increased risk of developing EoE, with higher risks associated with increasing frequency and doses. Three or more prescriptions in infancy correlated with an 80% increase in EoE risk.<br />   - **Maternal Antibiotic Use**: Antibiotic use during pregnancy also increased EoE risk for offspring. The risk was highest with antibiotic exposure in the third trimester and increased with the number of prescriptions.<br /><br />2. **Acid Suppressant Use**:<br />   - **Infant Acid Suppressants**: Any use of acid suppressants in infancy was strongly associated with an increased risk of EoE, with those receiving greater than 14 doses facing a significantly heightened risk.<br />   - **Maternal Acid Suppressants**: The study noted an increased EoE risk associated with maternal use during pregnancy, although data limitations prevented a thorough class and timing analysis.<br /><br />The research points to critical periods such as the third trimester and early infancy when exposure to these medications can have the greatest impact. The findings suggest that this developmental period is sensitive to factors that may influence the pathogenetic mechanisms of EoE.<br /><br />Conclusively, the study emphasizes the need for judicious use of antibiotics and acid suppressants during pregnancy and early life to potentially mitigate the risk of developing EoE. The evidence supports the hypothesis that early life exposures disrupting gut microbiome balance and immune responses could contribute to EoE pathogenesis. Further studies are recommended to explore different drug classes and assess genetic factors related to EoE.

Keywords

Eosinophilic Esophagitis

antibiotics

acid suppressants

maternal use

infant use

chronic inflammatory disease

pregnancy

early infancy

gut microbiome

immune responses