TITLE:
A Systematic Review of Proton Pump Inhibitors for the Prevention and Treatment of Preeclampsia and Gestational Hypertension
AUTHORS:
Manarangi De Silva, Fiona Brownfoot, Natalie J. Hannan, Susan P. Walker, Catherine A. Cluver, Anthea Lindquist, Stephen Tong, Roxanne Hastie
KEYWORDS:
Preeclampsia, Proton-Pump-Inhibitors
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.1,
January
4,
2019
ABSTRACT: Background: Preeclampsia is a hypertensive disorder of pregnancy
with a high rate of neonatal and maternal morbidity and mortality. The only
definitive treatment is delivery. Through pre-clinical studies, proton
pump inhibitors (PPIs), which are commonly and safely used in pregnancy, have been identified as potential
therapeutic agents. Objective: To undertake a systematic review
evaluating PPIs in the prevention and/or treatment of preeclampsia and
gestational hypertension. Search strategy: Electronic databases were
searched from inception to 2018. Search terms included preeclampsia, proton-pump
inhibitors, pregnancy-induced hypertension, lansoprazole, rabeprazole,
esomeprazole and omeprazole. Selection criteria: Studies were included if they were randomized
control trials, case-control or cohort studies on human subjects. Case reports, review articles, opinion pieces and
conference abstracts were excluded as well as studies with no or inappropriate
control arms. Data collection and
analysis: Only one eligible study was identified, so no analyses were able to be
performed. Main results: There was only one clinical trial eligible for
inclusion. This was a randomized clinical trial investigating the role of PPIs
in the treatment of preterm preeclampsia in a high-risk, inpatient setting.
This was a negative finding, with no change in the primary outcome of
prolongation of gestation between the PPI group and placebo control. Conclusion: There is a scarcity of clinical trials published
investigating the therapeutic potential of PPIs for preeclampsia and gestational
hypertension. Of the one available study, PPIs were not found to prolong
gestation among preterm preeclamptic patients compared
to placebo control. In order to further elucidate the clinical potential of
PPIs to prevent or treat preeclampsia, further trials are required.