Evidence map›Paper›PMID 39666165›Full record

ArticleDrug safety2025

Prenatal and Early Childhood Exposure to Proton Pump Inhibitors and Antibiotics and the Risk of Childhood Cancer: A Nationwide Population-Based Cohort Study.

Unnur Gudnadottir, Emma Fransson, Gustaf Ljungman, Anna Wikman, Erika Vlieghe, Lars Engstrand, Nele Brusselaers

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In one paragraph

Article in Drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Unnur GudnadottirDepartment of Microbiology, Tumour and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, Solna, 171 65, Stockholm, Sweden. unnur.gudnadottir@ki.se.ORCID 0000-0002-4663-9921
Emma FranssonDepartment of Microbiology, Tumour and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, Solna, 171 65, Stockholm, Sweden.
Gustaf LjungmanDepartment of Women's and Children's health, Uppsala University, Sjukhusvägen 7, 753 09, Uppsala, Sweden.
Anna WikmanDepartment of Women's and Children's health, Uppsala University, Sjukhusvägen 7, 753 09, Uppsala, Sweden.
Erika VliegheDepartment of Family Medicine and Population Health, Global Health Institute, University of Antwerp, 2610, Antwerp, Belgium.
Lars EngstrandDepartment of Microbiology, Tumour and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, Solna, 171 65, Stockholm, Sweden.
Nele BrusselaersDepartment of Microbiology, Tumour and Cell Biology (MTC), Centre for Translational Microbiome Research, Karolinska Institutet, Tomtebodavägen 16, Solna, 171 65, Stockholm, Sweden.

Funding

Vetenskapsrådet 2020-01058
6 · The paper itself

Abstract

backgroundOur microbiome is established during infancy, a time important for later health and long-term effects. Proton pump inhibitors and antibiotics are regularly prescribed during pregnancy. Both drugs cause microbiome disturbance and have been associated with increased cancer risk in adults, but effects of these drugs on the growing foetus and infant remain understudied.

aimThe aim of this study is to study the association between prenatal and early life proton pump inhibitor and antibiotics exposure and the risk of childhood cancer.

methodsThis study is a retrospective population-based cohort design, using registry data on all births (n = 722,372) in Sweden between 2006 and 2016, according to the STROBE checklist. For women who had multiple children in the timeframe of the study, only the first child during the time period was included in the cohort. Exposure was defined as either ≥ 1 proton pump inhibitor or antibiotics prescription during pregnancy, or during the first 2 years of life. Outcome was defined as cancer at any time during the follow-up or cancer after the age of 2 years for early life exposure. Multivariable Cox proportional hazard models were used to calculate hazard ratios.

resultsIn total, 1091 (0.2%) children were diagnosed with malignant cancer during the follow-up. Prenatal exposure to proton pump inhibitors and antibiotics were not associated with an increased risk of cancer. Regarding early life exposure, proton pump inhibitors were associated with an increased risk of cancer at age two or older (adjusted hazard ratio [aHR] 3.68, 95% confidence interval [CI] 2.24-6.06).

conclusionsWe did not find evidence that prenatal proton pump inhibitors and antibiotics were associated with overall childhood cancer. However, proton pump inhibitors during early life were associated with an increased risk of childhood cancer, but indication on drug use was not available and confounding by indication may be present.

Indexed as

Anti-Bacterial AgentsNeoplasmsPrenatal Exposure Delayed EffectsProton Pump InhibitorsAdultChildChild, PreschoolCohort StudiesFemaleHumansInfantInfant, NewbornMalePregnancyRegistriesRetrospective StudiesAnti-Bacterial AgentsProton Pump Inhibitors

Identifiers

PMID39666165
PMCPMC11903606

What Socratic holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.