Early Acid Suppression Therapy Exposure and Fracture in Young Children.

摘要: BACKGROUND: Acid suppression therapy (AST), including proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs), is frequently prescribed to treat symptomatic gastroesophageal reflux in otherwise healthy infants. PPI use has been associated with increased fracture risk older adults; 2 preliminary studies children have conflicting results. METHODS: A retrospective cohort of born 2001 2013 who were followed for ≥2 years was formed. Those osteogenesis imperfecta, cholestasis, or child maltreatment excluded. Prescription data used identify AST prescription before age 1 year. International Classification Diseases, Ninth Revision, Clinical Modification codes identified fractures after Cox proportional hazard analysis assessed adjusted sex, prematurity, low birth weight, previous fracture, anti-epileptics, overweight obesity. RESULTS: Of 851 631 included children, 97 286 (11%) the first year life; 7998 (0.9%) PPI, 71 578 (8%) H2RA, 17 710 (2%) both a H2RA. Infants had an earlier median (3.9 vs 4.5 years). After adjustment, (21%) H2RA (30%), but not alone. Longer duration treatment hazard. CONCLUSIONS: Infant alone together H2RAs childhood hazard, which appears amplified by days initiation ASTs. Use infants should be weighed carefully against possible fracture.