While heartburn in pregnancy is common, doctors are often reticent to prescribe medications called proton-pump inhibitors because of worries that the drugs may not be safe to the growing babies.
But a new study from Denmark finds doctors and their pregnant patient have little reason to be concerned: overall, the drugs don't appear to raise the risk of birth defects.
But at least one experts say the findings should be interpreted with caution.
For the study, which is published in the New England Journal of Medicine, Danish researchers looked at nearly 841,000 births registered with national databases, from 1996 to 2008.
In about 5,000 cases, the mothers had taken PPIs at some time during the four weeks prior to pregnancy through their first trimester.
The researchers found no significant differences in birth defects among the women who took PPIs compared with the women who didn't.
Overall, 3.4 percent of babies whose mothers had taken the drugs had a major birth defect, compared to 2.6 percent of the babies not exposed.
Interestingly, those women who had taken the medications before they got pregnant did appear to be at risk for having a baby with birth defects. In fact, those who had taken a PPI during the four weeks prior to pregnancy (with the notable exception of Prilosec (omeprazole)) saw an increased risk of major birth defects of 39 per cent.
The authors of the study dismissed the finding as biologically implausible. They note that the medications do not stay in the body for more than a few hours, not weeks.
Still, the author of an accompanying editorial, Dr. Allen A. Mitchell, Slone Epidemiology Center at Boston University, says the risk of pre-pregnancy exposure cannot be ruled out.
"As the authors acknowledge, however, these data provide only a broad — and incomplete — overview," Mitchell writes.
He notes that while the researchers say the study offers reassurance that, as a group, PPIs don't increase the overall risk of birth defects, it wasn't large enough to rule out an effect of individual drugs on specific birth defects, such as cleft lip.
"Until we have a better understanding of what might explain [the finding of an increased risk prior to conception], it may be prudent to consider omeprazole to be the PPI of choice when PPI treatment is clearly needed for women of childbearing potential and particularly for those who are planning to become pregnant," he writes.
t C o s (W� Ȥ� razole to be the PPI of choice when PPI treatment is clearly needed for women of childbearing potential and particularly for those who are planning to become pregnant," he writes.
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