Early-life exposure to acid suppressants may up risk of fractures during childhood

Exposure to acid-suppressive therapy during the first year of life appear to come with a small but significant increase in the risk of fractures, according to a study.

The study included a propensity-matched cohort of 13,894 children who used acid suppressants during the first year of life and 41,418 children who had no exposure to acid suppressants. All children were followed from the end of the first year of life until the earliest of the following: an outcome event (either fracture or nonfracture injury), age of 10 years, or August 2022.

The primary outcome was cumulative incidence of fractures, analysed using regression models.

Results showed that children with exposure to acid-suppressive therapy had a significantly higher cumulative incidence of fracture than children without such exposure (23.7 percent vs 21.7 percent; p<0.001).

Acid-suppressive therapy use during infancy was associated with an 11-percent increase in the risk of developing fracture during childhood (hazard ratio [HR], 1.11, 95 percent confidence interval [CI], 1.06–1.16).

The risk increase was higher among children with at least three vs zero acid-suppressive therapy purchases (HR, 1.25, 95 percent CI, 1.13–1.39). However, the risk was smaller among children with one or two vs zero acid-suppressive therapy purchases (HR, 1.09, 95 percent CI, 1.04–1.14).

Acid-suppressive therapy use in the first year of life was also associated with nonfracture injuries (HR, 1.09, 95 percent CI, 1.04–1.13).