Proton Pump Inhibitor Use in Infancy and Childhood Fracture Risk

Investigators from multiple institutions conducted a retrospective cohort study to assess whether acid suppression therapy (AST) in the first year of life is associated with childhood fracture. Children were eligible if they were born between 2001 and 2013 and received continuous care in the Military Healthcare System for at least the first 2 years and up to 14 years of life. Demographic variables and covariates linked to fracture risk (preterm birth, low birth weight, obesity, antiepileptic medication use, and fracture before age 1 year) were obtained from military records.

The primary predictor was ≥1 outpatient prescription for AST in the first year of life as determined from civilian and military outpatient pharmacy records. AST therapy included a proton pump inhibitor (PPI), a histamine H₂-receptor antagonist (H2RA), or …