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Published on: January 27, 2019

Use of Proton Pump Inhibitors in Infants: Nationwide Cohort Study Based on the French EPI-MERES Register

Marion Lassalle1, Sydney Sebban2, Cécile Talbotec3

  • 1EPI-PHARE, Epidemiology of Health Products (French National Agency for the Safety of Medicines and Health Products [ANSM], and French National Health Insurance [CNAM]), Saint-Denis Cedex, Saint-Denis, France.

Journal of Pediatrics. Clinical Practice
|June 8, 2026
PubMed

Insights

Proton pump inhibitor (PPI) use in French infants under one year has significantly increased since 2010, especially in those without diagnosed gastroesophageal reflux disease (GERD). This rise is linked to GERD risk factors and higher maternal socioeconomic status, prompting a need for further research into prescribing patterns.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Public Health

Background:

  • Proton pump inhibitors (PPIs) are widely used for acid-related disorders.
  • Understanding trends in infant PPI use is crucial for optimizing treatment and minimizing potential risks.
  • Previous studies have not fully elucidated the patterns and determinants of PPI use in infants under one year of age.

Purpose of the Study:

  • To determine the frequency and characteristics of proton pump inhibitor (PPI) use in children before the age of one year in France.
  • To analyze the evolution of PPI prescribing patterns over time.
  • To identify factors associated with PPI use in this age group.

Main Methods:

  • A cohort study utilizing the EPI-MERES register from the French National Health Data System.
  • Inclusion of children born between 2010 and 2021.
  • Logistic regression models to assess associations between PPI use and demographic, socioeconomic, medical, and healthcare utilization factors.

Main Results:

  • Over 8.2 million children were included, with 703,891 (8.6%) using PPIs before age one.
  • PPI use incidence was higher in children with diagnosed GERD (54.4/100 person-years) but increased more significantly in those without (7.9/100 person-years, +63.6%).
  • Factors associated with PPI use in infants without inpatient GERD diagnosis included prematurity, digestive/respiratory/neurological diseases, and higher maternal socioeconomic status.

Conclusions:

  • PPI use before age one has markedly increased in France since 2010, particularly in infants without diagnosed GERD.
  • High maternal socioeconomic level emerged as a significant factor associated with PPI use, beyond established GERD risk factors.
  • Further investigation into the drivers of PPI prescribing is essential to curb potentially unnecessary infant exposure.
Abstract

Keywords:
childrengastro-oesophageal reflux diseaseproton pump inhibitor

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