Interventions for heartburn in pregnancy

  • Review
  • Intervention

Authors

  • James P Neilson

    Corresponding author
    1. The University of Liverpool, Department of Women's and Children's Health, Liverpool, UK
    • James P Neilson, Department of Women's and Children's Health, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, UK. jneilson@liverpool.ac.uk.

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Abstract

Background

Heartburn is a common symptom in pregnancy affecting up to 80% of women in the third trimester. The reasons for the increase in symptoms in pregnancy are not well understood, but the effects of pregnancy hormones on the lower oesophageal sphincter and gastric clearance are thought to play a part. A range of interventions have been used to relieve symptoms including advice on diet and lifestyle, antacids, antihistamines, and proton pump inhibitors. The safety and effectiveness of these interventions to relieve heartburn in pregnancy have not been established.

Objectives

To assess the effect of interventions to relieve heartburn in pregnancy.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2008). We updated this search on 10 November 2012 and added the results to the awaiting classification section of the review.

Selection criteria

We included randomised controlled trials evaluating interventions to relieve heartburn.

Data collection and analysis

We assessed eligibility for inclusion and extracted data independently.

Main results

Three studies were eligible for inclusion, together they included a total of 286 women. All three were placebo controlled trials, each examining a different medication to relieve heartburn (intramuscular prostigmine, an antacid preparation and an antacid plus ranitidine). All three produced positive findings in favour of the intervention groups. It was not possible to pool findings from studies to produce an overall treatment effect.

Authors' conclusions

There was little information to draw conclusions on the overall effectiveness of interventions to relieve heartburn in pregnancy.

[Note: the two citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

Plain language summary

Interventions for heartburn in pregnancy

Heartburn affects more than two-thirds of women in late pregnancy. Usually it is not serious, but symptoms can be very distressing to pregnant women. There are many different interventions to relieve heartburn including advice on diet and lifestyle and a range of medicines (many of which are available over the counter without prescription). The review authors identified three randomised controlled trials including a total of 286 women focusing on three different heartburn medications. While the results of the individual trials were positive (women described some relief from symptoms), overall it was concluded that there is little information on the safety or effectiveness of drugs used to treat heartburn in pregnancy. More information is needed on this common and distressing condition.