Alginate Therapy for Gastroesophageal Reflux in Pregnancy: A Scoping Review

OBJECTIVE: Alginate therapies are a promising option for managing gastroesophageal reflux (GERD), but most treatments are not recommended during pregnancy. This scoping review aimed to summarize the current outcomes research on the use of alginate therapy for treating GERD during pregnancy. DATA SOURCES: EMBASE, MEDLINE, CINAHL, and Web of Science were searched from database inception to November 1, 2024. Reference lists of included studies were also searched. REVIEW METHODS: We included randomized controlled trials (RCTs) and non-randomized studies evaluating alginate use in pregnant individuals with GERD. Screening and data extraction were performed by three reviewers in duplicate. Extracted data included study design, location, population, study group allocation, and clinical outcomes. Descriptive statistics were calculated using Microsoft Excel. RESULTS: Two RCTs and two prospective cohort studies met the inclusion criteria. Of the two RCTs identified, one evaluated an alginate formulation against a proton pump inhibitor (PPI), and the other against a magnesium-aluminum antacid. Cohort studies reported investigator- and patient-rated treatment success at 89.7% and 90.0%, respectively, with 92.2% of participants having symptom relief within 20 min. Similar improvements in heartburn intensity and frequency were found when comparing alginates and antacids. Few maternal adverse effects were reported, and no fetal or neonatal outcomes were related to treatment. Safety profiles of alginates were comparable to PPIs and antacids. CONCLUSION: Current literature on alginate therapy in pregnant women may suggest potential for symptom relief and favorable tolerability, but current evidence is limited by the few available prospective studies. LEVEL OF EVIDENCE: N/A.