ArticleJournal of pediatrics. Clinical practice2026
Use of Proton Pump Inhibitors in Infants: Nationwide Cohort Study Based on the French EPI-MERES Register.
Article in Journal of pediatrics. Clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To describe the frequency and characteristics of proton pump inhibitor (PPI) use before the age of 1 year and its evolution over time in France. Study design: This cohort study, based on the EPI-MERES register built from the French National Health Data System, included children born between 2010 and 2021. PPI use was identified through prescriptions before age 1 year. Logistic regression models were used to assess factors associated with PPI use, including demographic and socioeconomic characteristics, medical characteristics, and healthcare use indicators. Results: Among the 8 222 100 children included, 703 891 were PPI users. The incidence of PPI use was 54.4 per 100 person-years among children with hospital-diagnosed gastroesophageal reflux disease (GERD) (+ 33.6% between 2010 and 2021), and 7.9 per 100 person-years in those without (+ 63.6%). In children without an inpatient diagnosis of GERD, PPI use was associated with known risk factors of GERD (extreme prematurity, aOR, 1.91 [95% CI, 1.82-2.01]; digestive diseases, aOR, 5.60 [95% CI, 5.49-5.71]; respiratory diseases, aOR, 2.73 [95% CI, 2.70-2.75]; neurological diseases, aOR, 1.59 [95% CI, 1.56-1.62]), and with high maternal socioeconomic level (first quintile of deprivation index [least deprived] vs fifth quintile [most deprived], aOR, 1.80 [95% CI, 1.79-1.82]; and monthly salary of ≥€2000 vs beneficiaries of the complementary solidarity health insurance, aOR, 1.92 [95% CI, 1.91-1.94]). Conclusions: PPI use before age 1 has increased sharply in France since 2010, particularly in infants without an inpatient diagnosis of GERD. Beyond known risk factors for GERD, it was associated with high maternal socioeconomic level. Further work to understand the determinants of PPI prescribing is essential to reduce unnecessary exposure.
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