Proton Pump Inhibitor Use During Pregnancy Linked to Increased Risk of Infection
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on June 22nd, 2026
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Proton pump inhibitors are commonly prescribed to treat gastroesophageal reflux disease by suppressing gastric acid production. While effective, gastric acid plays an important role in preventing bacterial overgrowth and limiting the entry of pathogens into the gastrointestinal tract. Consequently, long-term proton pump inhibitors use has been associated with an increased risk of infection. Because hormonal and physiological changes during pregnancy often worsen reflux symptoms, proton pump inhibitors are frequently used in pregnant women. A recent study published in the Lancet examined whether proton pump inhibitor use during pregnancy is associated with an increased risk of maternal infections during pregnancy and the postpartum period.
Funding Source(s): Swedish Research Council, Karolinska Institutet, among others.
The retrospective cohort study analyzed more than 1.5 million health records from women with singleton pregnancies in Sweden between 2006 and 2019. Among these women, approximately 42,000 received at least one prescription refill for a proton pump inhibitor between the 90 days preceding their last menstrual period and the end of the first trimester.
The researchers found that women who used proton pump inhibitors during early pregnancy had a higher overall incidence of infection during pregnancy and within 90 days after delivery. Specifically, 49.7% of proton pump inhibitor users experienced at least one infection, compared with 36.8% of women who did not receive proton pump inhibitors. The strongest association was observed for gastrointestinal infections, with a 109% increase in risk. Elevated risks were also observed for respiratory tract infections (73%), genitourinary tract infections (60%), and skin infections (49%). Overall, proton pump inhibitor use was associated with a 26% increase in the risk of infection, while the risk of moderate-to-severe infections was increased by 36%. Based on these findings, the researchers concluded that the benefits and risks of proton pump inhibitor therapy should be carefully weighed in pregnant individuals, particularly those who may already be at increased risk of infection. While proton pump inhibitors remain effective for managing reflux symptoms, alternative strategies may be worth considering when clinically appropriate.
Funding Source(s): Swedish Research Council, Karolinska Institutet, among others.
The retrospective cohort study analyzed more than 1.5 million health records from women with singleton pregnancies in Sweden between 2006 and 2019. Among these women, approximately 42,000 received at least one prescription refill for a proton pump inhibitor between the 90 days preceding their last menstrual period and the end of the first trimester.
The researchers found that women who used proton pump inhibitors during early pregnancy had a higher overall incidence of infection during pregnancy and within 90 days after delivery. Specifically, 49.7% of proton pump inhibitor users experienced at least one infection, compared with 36.8% of women who did not receive proton pump inhibitors. The strongest association was observed for gastrointestinal infections, with a 109% increase in risk. Elevated risks were also observed for respiratory tract infections (73%), genitourinary tract infections (60%), and skin infections (49%). Overall, proton pump inhibitor use was associated with a 26% increase in the risk of infection, while the risk of moderate-to-severe infections was increased by 36%. Based on these findings, the researchers concluded that the benefits and risks of proton pump inhibitor therapy should be carefully weighed in pregnant individuals, particularly those who may already be at increased risk of infection. While proton pump inhibitors remain effective for managing reflux symptoms, alternative strategies may be worth considering when clinically appropriate.