Taking paracetamol during pregnancy is not associated with an increased risk of autism in the unborn child

Limiting the use of medications during pregnancy as a precaution is a rule designed to avoid causing any changes in the baby’s body. In recent years, a large amount of research has focused on gestational medication use for specific pathologies, but also with more frequent consumption, as in the case paracetamola substance with an analgesic and antipyretic effect, to which some works are devoted, for example, published in International Journal of Epidemiologywhich suggests it may increase risk of autism and attention deficit hyperactivity disorder (ADHD) in children of pregnant women who consumed it during pregnancy.

Per, new research published in PITexamined the association of acetaminophen use during pregnancy with risk autism, ADHD and mental retardation in newborns when asked whether the use of paracetamol during pregnancy will increase their risk of neurodevelopmental disorders.

WHAT ARE CONDITIONING FACTORS?

The findings show that “paracetamol use during pregnancy was not associated with the risk of autism, ADHD or mental retardation in children in sibling control analysis. This suggests that associations observed in other models could be due to family interfering factors”indicates Victor H. Ahlquistbelonging Karolinska Institute of Sweden.

This is a population-based study using data from a national cohort of over 2.4 million children were born in Sweden., including undisclosed siblings to the drug before birth, where models without sibling controls found a slightly increased risk of autism and ADHD associated with acetaminophen use during pregnancy. However, “analysis of matched sibling pairs no evidence of increased risk found autism (risk index 0.98), ADHD (risk index 0.98), associated with the use of paracetamol,” Ahlquist details.

According to the researchers, these results mean that acetaminophen use during pregnancy was not associated with the risk of autism, ADHD or mental retardation in children in a sibling control analysis. This suggests that observed associations in other models they may have been due to confounding factors.

Mara Parellada, Head of the Autism Spectrum Disorders Unit at the Gregorio Marañon Hospital in Madridbrings to the table one of the aspects that this analysis highlights the importance of interpret research correctly. The fundamental problem in this sense is that confuse associations with cause or interpret associations with cause. “Demonstrating cause and effect is very difficult because it would require, among other things, prospective or longitudinal studies.”

ASSOCIATION IS NOT A REASON

In recent years, the psychiatrist notes, studies have been conducted in which mothers exposed to the drug have more children with autism compared to mothers not exposed to the drug. But this is just an association. “It may have nothing to do with the reason because there may be another problem or change that the mother is taking the drug for and that this is actually the cause. There must be another unknown interfering factorfor example, mothers have more migraines, more infections,” Parellada emphasizes.

In fact, research suggests that the statistically increased risk of neurodevelopmental disorders with neonatal acetaminophen exposure may be due to other factors. This study shows that there are many various family and health factors which are associated with both acetaminophen use and neurodevelopmental disorders. “It is likely that genetics also play a role, but future research is needed to clarify this possible significance,” according to Renee Gardner belonging Karolinska Institute of Sweden.

This nationwide cohort analysis with sibling controls included a population-based sample of 2,480,797 children born between 1995 and 2019 in Sweden, with follow-up until 31 December 2021. Paracetamol use during pregnancy was recorded prospectively.from antenatal and prescription records.

A total of 185,909 children (7.49%) were exposed to paracetamol during pregnancy. gross absolute risks at 10 years of age for those not exposed to paracetamol compared with those exposed to paracetamol were 1.33% vs 1.53% for autism, 2.46% vs 2.87% for ADHD and 0 .70% compared to 0.82% for mental retardation. In models without sibling controls, acetaminophen use during pregnancy or no acetaminophen use during pregnancy was associated with a slightly increased risk of autism.

To eliminate unobserved confounding factors, we also analyzed complete pairs of siblings. A sibling control analysis found no evidence that acetaminophen use during pregnancy was associated with autism, ADHD, or intellectual disability. Likewise, there was no evidence that dose-response diagram in a sibling control analysis. For example, in autism, compared with no acetaminophen use, people with low (<25-й процентиль), средним (25-75-й процентиль) и высоким (>75th percentile) mean daily acetaminophen use had RRs of 0.85, 0.96, and 0.88. , respectively.

A new study that Parellada says they are conducting well thought out strategy and which is based on sibling control and through which they note that siblings of children without autism are also exposed to more paracetamol than siblings of children with autism.

The researchers followed each child until age 26, observing slight increase in risk autism, ADHD and mental retardation in the general population, as found in previous similar studies reporting such an association. However, the authors did not find an increased risk for either condition when compared to siblings: One sibling was exposed to acetaminophen in utero before birth, but the other sibling was not.