{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:46:15Z","timestamp":1747183575474,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T00:00:00Z","timestamp":1583366400000},"content-version":"am","delay-in-days":366,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T00:00:00Z","timestamp":1551744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009898","name":"Defense Health Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009898","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gastroesophageal reflux disease is a common condition in pregnancy and is often managed with medications. Specific medications have been linked to osteoporosis and fragility fracture in older adults. This study assessed whether maternal use of antireflux medications is associated with early childhood fracture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>TRICARE beneficiaries during pregnancy were retrospectively identified using the Military Health System Data Repository and pharmacy data. Mother and infant data were linked; children with continuous enrollment for the first 5\u00a0years of life were included. Differences in the children\u2019s fracture risk were analyzed through multivariate analysis, adjusting for region, rank, and military branch of service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 378\u00a0150 patients comprised the final cohort with 3.3% (n\u00a0=\u00a012\u00a0479) prescribed antireflux medications during pregnancy. A significant decrease in fracture rate was found among children of women who were prescribed antireflux medications during pregnancy compared with those who were not (0.8% vs 1.2%, RR\u00a0=\u00a00.70, 95% CI 0.58\u20100.85). There was no difference in fracture risk between histamine type 2 receptor antagonists and proton pump inhibitors. A significantly increased fracture incidence was seen in pregnancies with multiple gestations (RR\u00a0=\u00a01.38, 95% CI 1.04\u20101.85). There was no identified difference in fracture risk for women with gestational diabetes, preeclampsia, preterm or low birthweight, chronic hypertension, induction, or breech presentation when compared to women without these conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found no increase in early childhood fracture risk with maternal antireflux medication use. This suggests that prenatal exposure to antireflux medications does not affect fetal bones to a clinically significant extent.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12423","type":"journal-article","created":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T09:30:04Z","timestamp":1551778204000},"page":"656-662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prenatal use of medications for gastroesophageal reflux disease and early childhood fracture risk"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2518-0071","authenticated-orcid":false,"given":"Heather L.","family":"Wolfe","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Walter Reed National Military Medical Center Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared A.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Walter Reed National Military Medical Center Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-6710","authenticated-orcid":false,"given":"Anju","family":"Ranjit","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Howard University Hospital Washington District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Banaag","sequence":"additional","affiliation":[{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda Maryland"},{"name":"Uniformed Services University of the Health Sciences Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1377-8615","authenticated-orcid":false,"given":"Tracey","family":"P\u00e9rez Koehlmoos","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine T.","family":"Witkop","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2016.02.005"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02654.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.64"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.24.2947"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.01.007"},{"key":"e_1_2_6_7_1","unstructured":"U.S. Food and Drug Administration.FDA Drug Safety Communication. Possible increased risk of fractures of the hip wrist and spine with the use of proton pump inhibitors.2011.https:\/\/www.fda.gov\/drugs\/drugsafety\/postmarketdrugsafetyinformationforpatientsandproviders\/ucm213206.htm. Accessed May 10 2017."},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-012-2112-9"},{"key":"e_1_2_6_9_1","first-page":"8893","article-title":"Acid\u2010suppressive medications and risk of fracture: an updated meta\u2010analysis","volume":"8","author":"Cai D","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.23.13.74S.31929"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.02.007"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.108"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01352010"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/beem.2002.0199"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.05.032"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181e35be8"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-007-0256-6"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181bb14c8"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-014-2690-9"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.040902"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbirt.12423","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.12423","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/birt.12423","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/am-pdf\/10.1111\/birt.12423","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.12423","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T20:23:22Z","timestamp":1694204602000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.12423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,5]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1111\/birt.12423"],"URL":"https:\/\/doi.org\/10.1111\/birt.12423","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"type":"print","value":"0730-7659"},{"type":"electronic","value":"1523-536X"}],"subject":[],"published":{"date-parts":[[2019,3,5]]},"assertion":[{"value":"2018-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}