Prematurity and Early Childhood Fracture Risk*

Wagner, Kari L.; Wagner, Scott C.; Susi, Apryl; Gorman, Gregory; Hisle-Gorman, Elizabeth

doi:10.1542/peds.141.1_meetingabstract.757

Cited by 2 publications

(3 citation statements)

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“… 29 With anti-reflux medications, there is emerging evidence of adverse effects in preterm infants, including necrotizing enterocolitis, late-onset infections, alteration of the intestinal microbiome, fracture risk, and death. 6 , 11 , 30 This report highlights the need for increased surveillance of their use in the community after NICU discharge.…”

Section: Discussionmentioning

confidence: 93%

Medication utilization in children born preterm in the first two years of life

et al. 2021

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Objective: To compare medications dispensed during the first two years in children born preterm and full-term. Study Design: Retrospective analysis of claims data from a commercial national managed care plan 2008–2019. 329 855 beneficiaries were enrolled from birth through two years, of which 25 408 (7.7%) were preterm (<37 weeks). Filled prescription claims and paid amount over two years were identified. Results: In preterm children, the number of filled prescriptions was 1.4 times and cost was 3.8 times that of full-term children. Number and cost of medications were inversely related to gestational age. Differences peak at 4–9 months and resolve by 19 months after discharge. Palivizumab, ranitidine, albuterol, lansoprazole, budesonide, and prednisolone had the greatest differences in utilization. Conclusion: Prescription medication utilization among preterm children under two is driven by palivizumab, anti-reflux, and respiratory medications, despite little evidence regarding efficacy for many medications, and concern for harm with certain classes.

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Section: Discussionmentioning

confidence: 93%

Medication utilization in children born preterm in the first two years of life

et al. 2021

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“…Six studies (Freedberg et al, 2015a;Fedida et al, 2019;Malchodi et al, 2019;Wagner et al, 2019;Fleishman et al, 2020;Wang et al, 2020) were included in our meta-analysis following the abovementioned exclusion and selection procedure. The main characteristics of the included studies are summarized in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The main characteristics of the included studies are summarized in Table 1. They were published between 2015 and 2020 including five cohort studies (Fedida et al, 2019;Malchodi et al, 2019;Wagner et al, 2019;Fleishman et al, 2020;Wang et al, 2020) and one case-control study (Freedberg et al, 2015a). Three studies were conducted in North America (Malchodi et al, 2019; Wagner et al, 2019;Fleishman et al, 2020), two in Europe (Freedberg et al, 2015a;Wang et al, 2020), and one in Israel (Fedida et al, 2019 selected observational studies showed a reasonably good quality.…”

Section: Study Characteristicsmentioning

confidence: 99%

Acid-Suppressive Drugs and Risk of Fracture in Children and Young Adults: A Meta-Analysis of Observational Studies

Xie

Liu

et al. 2021

Front. Pharmacol.

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Background: Recent studies have suggested that proton pump inhibitors (PPIs) and histamine type 2 receptor antagonists (H2RAs) may increase the risk of fracture. We performed a meta-analysis to evaluate the risk of fracture with PPIs and H2RAs use in children and young adults.Methods: PubMed, EMBASE database, Cochrane Library, and Web of Science for relevant articles published before May 2021 were searched. We included all the observational studies reporting on the risk of fracture with acid-suppressive drug (PPIs and H2RAs) use in children and young adults. We calculated pooled risk ratios (RRs) for fracture using random-effects models and conducted subgroup analyses.Results: A total of six studies were included in our analysis. Pooled analysis of PPIs use showed significant risk for fracture (RR = 1.23; 95% CI, 1.12–1.34; I2 = 79.3), but not significant for PPIs combined with H2RAs use (RR = 1.22; 95% CI, 0.94–1.60; I2 = 44.0%), as well as for H2RAs use alone (RR = 1.08; 95% CI, 0.94-1.24; I2 = 84.1%). Grouping of studies by region showed a significantly increased fracture risk with PPIs use in North America (RR = 1.24; 95% CI, 1.16–1.32; I2 =0.0%) than in Europe (RR = 1.23; 95% CI, 1.00–1.52; I2 = 94.6%) and Asia (RR = 1.10; 95% CI, 0.96–1.25). However, there was no significant association between the H2RAs use and the fracture risk in North America (RR = 1.08; 95% CI, 1.00–1.09; I2 = 0.0%). Moreover, PPIs use showed an increased risk of fracture in women (RR = 1.13; 95% CI, 1.07–1.19; I2 = 0.0%), whereas there was no significant association between the PPIs use and the risk of fracture in men (RR = 0.93; 95% CI, 0.66–1.31; I2 = 0.0%).Conclusion: PPIs use alone could increase the risk of fracture in children and young adults, but not for PPIs combined with H2RAs use or H2RAs use alone. Clinicians should exercise caution when prescribing PPIs for patients.

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Prematurity and Early Childhood Fracture Risk*

Cited by 2 publications

References 0 publications

Medication utilization in children born preterm in the first two years of life

Medication utilization in children born preterm in the first two years of life

Acid-Suppressive Drugs and Risk of Fracture in Children and Young Adults: A Meta-Analysis of Observational Studies

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