CONCLUSION
This study adds to the growing body of evidence that PPIs do not prevent preeclampsia, despite their ability to reduce the secretion of sFlt-1. Furthermore, calcium-based antacids did not reduce the risk of preeclampsia in this population of pregnant women, even in high doses. Based on these results, choice of treatment of symptoms of gastroesophageal reflux does not need to be influenced by potential beneficial side effects with regard to the risk of preeclampsia. Nevertheless, benefit-risk assessment should also include other relevant outcomes for maternal and child health, which slightly favour the choice of calcium-based antacids.53 Future research may focus on identifying specific groups of women for whom calcium-based antacids or PPIs might reduce the risk of preeclampsia, in particular early-onset preeclampsia.