Using the common pain-relieving
medication acetaminophen during pregnancy was associated with increased risk
for multiple behavioral problems in children, according to an article published
online by JAMA Pediatrics.
Acetaminophen is generally considered
safe in pregnancy and is used by a many pregnant women for pain and fever.
Evie Stergiakouli, Ph.D., of the
University of Bristol, United Kingdom, and coauthors analyzed data for 7,796
mothers enrolled in the Avon Longitudinal Study of Parents and Children between
1991 and 1992 along with their children and partners. The authors examined
associations between behavioral problems in children and their mothers'
prenatal and postnatal acetaminophen use, as well as acetaminophen use by their
partners.
Questionnaires assessed acetaminophen
use at 18 and 32 weeks during pregnancy and when children were 5 years old.
Behavioral problems in children reported by mothers were assessed by
questionnaire when children were 7 years old.
At 18 weeks of pregnancy, 4,415
mothers (53 percent) reported using acetaminophen and 3,381 mothers (42
percent) reported using acetaminophen at 32 weeks. There were 6,916 mothers (89
percent) and 3,454 partners (84 percent) who used acetaminophen postnatally. The
study reports 5 percent of children had behavioral problems.
Study results suggest prenatal use of
acetaminophen by mothers at 18 and 32 weeks of pregnancy was associated with
increased risk of conduct problems and hyperactivity symptoms in children, and
maternal acetaminophen use at 32 weeks of pregnancy also was associated with
higher risk for emotional symptoms and total difficulties in children.
Postnatal maternal acetaminophen use
and acetaminophen use by partners were not associated with behavioral problems.
Because the associations were not observed in these instances, the authors
suggest that this may indicate that behavioral difficulties in children might
not be explained by unmeasured behavioral or social factors linked to
acetaminophen use.
Study limitations include a lack of
information on dosage or duration of acetaminophen use.
"Children exposed to
acetaminophen use prenatally are at increased risk of multiple behavioral
difficulties. ... Our findings suggest that the association between acetaminophen
use during pregnancy and offspring behavioral problems in childhood may be due
to an intrauterine mechanism. Further studies are required to elucidate
mechanisms behind this association as well as to test alternatives to a causal
explanation. Given the widespread use of acetaminophen among pregnant women,
this can have important implications on public health advice," the authors
write.
But the authors also caution: "However, the risk of
not treating fever or pain during pregnancy should be carefully weighed against
any potential harm of acetaminophen to the offspring."
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