Paracetamol during pregnancy is not linked to autism in children

According to the Ministry of Health’s 2011 drug management report, 92.4% of them take some kind of medication during this period. However, its intake is especially controlled, taking into account the possible consequences of such intake. In the largest study to date of paracetamol during pregnancy – as analgesic and antipyreticThe researchers found no evidence to support a causal relationship between use during pregnancy and an increased risk of autism, attention deficit hyperactivity disorder (ADHD), and mental retardation in children.

The findings, based on data from a national cohort of more than 2.4 million children born in Sweden between 1995 and 2019, including siblings not exposed to the drug before birth, were published this week in the journal. Magazine American Medical Association (JAMA) by researchers from the Dornsife School of Public Health in Drexel (USA) and the Karolinska Institutet in Sweden.

Renee Gardnerco-author of the article and researcher from Karolinska, explains to SINC the importance of this new work: “In 2021, a group of researchers published in Nature Reviews Endocrinology

“consensus statement stating that pregnant women should not use acetaminophen due to existing research examining the possibility that this compound disrupts neurodevelopment and interferes with endocrine signaling.”

“This threatened to increase fear and anxiety among expectant parents around the world, and we knew there were some significant limitations to existing research examining the link between paracetamol and neurodevelopmental disorders,” he adds.

26-year follow-up

After following each child for 26 years after birth, the team found a small increased risk autism, ADHD and mental retardation in the general population, as observed in previous similar studies reporting this association.

However, the authors did not observe an increased risk of any of these conditions when comparing siblings when one was exposed to acetaminophen in utero before birth and the other was not.

“When we compared children, we saw exactly the same associations that have been described in other populations, with a 26% increase in the risk of autism associated with paracetamol use. Certainly, when we controlled for different maternal indications in our models, this risk was reduced by 5% to 7% more for each of the neurodevelopmental outcomes we wanted to study,” he told SINC. Brian Leelead author and Professor Dornsife.

There is no cause-and-effect relationship between consumption and risk.

Because siblings share much of their genetic backgroundAs well as similar exposure to many of the same environmental factors during development, comparisons between them help control for these common factors that are otherwise difficult to measure in epidemiological studies, the authors note.

“Acetaminophen users differ from non-users, and standard statistical analyzes without sibling controls cannot capture all the differences,” Lee notes. “When we looked at siblings, we saw no difference in risk between exposed and unexposed siblings.”

Only about 7.5% of the study sample—185,909 children—were exposed to acetaminophen during pregnancy. In previous studies, its use during pregnancy varied widely depending on the study setting; a study in Denmark reported a use of 6.2%, and a study in the United States reported a use 10 times higher.

“Our analysis shows that there is substantial evidence that the correlation between acetaminophen use during pregnancy and the risk of neurodevelopmental disorders in children is likely not due to a causal relationship between them,” he continues.

“Encouraging” results

In 2015, the US Food and Drug Administration said that research on over-the-counter pain relievers is “too limited to make recommendations” but noted that “severe, persistent pain that is not treated effectively during pregnancy may lead to depression.” , anxiety and high blood pressure in the mother.”

The authors therefore insist that all patients follow their doctor’s advice regarding whether paracetamol is safe for them and their unborn children. “We hope our findings will provide some reassurance to expectant parents when they are faced with the sometimes stressful decision of whether or not to take these medications during pregnancy when they are experiencing pain or fever,” Gardner says.

Although the study used data on paracetamol prescriptions and pregnant women’s reports to their midwives during antenatal care and may not capture all over-the-counter drug use in all patients, the results represent data from a large representative sample and control for many other factors that may be associated with disorders of neuropsychic development.

“This work may provide doctors with more information so they can counsel their pregnant patients if they have any concerns about the risk of neurodevelopmental disorders in their children,” Lee concludes.

Link:

Victor H. Ahlquist and others: Acetaminophen use during pregnancy and the risk of autism, ADHD, and mental retardation in children. PIT 2024