December 2, 2022

Does taking paracetamol during pregnancy affect children?

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Research suggests a link between the drug and children with behavioral and sleep problems, but experts say other factors could be at play.

Paracetamol is one of the few “relatively safe” drugs for the treatment of pain during pregnancy.


New US research has found an association between prenatal exposure to paracetamol and problems with attention and sleep in offspring at age three.


After adjusting for confounding variables, including stress, researchers found that children of women who used paracetamol during pregnancy were 23% more likely to display sleep problems and 21% more likely to display sleep problems. attention compared to those whose mothers did not use acetaminophen during pregnancy.


Posted in OLPthe study reported that children who were exposed to paracetamol during pregnancy scored significantly higher on two of the seven Child Behavior Checklist (CBCL) syndrome scales – sleep problems and attention problems – compared to those who were not.


The research included 2423 mother-child pairs and used the CBCL for ages 1.5 to 5 years, with mothers assessing their own children.


However, while children of mothers who took paracetamol scored significantly higher on sleep and attention problems, experts have expressed suspicion about how the results were determined.


Gavin Pereira, professor of epidemiology and biostatistics at Curtin University, said newsGP in studies such as this, it is difficult to rule out a problem called ‘confounding by indication’.


“These results were assessed by the mothers, rather than a relatively more independent party like a teacher or clinician,” he said.


“The very fact that paracetamol was taken indicates an underlying problem experienced by the mother which could be transmitted directly or indirectly to the child. It is plausible that anxious parents are more likely to both take paracetamol and report attention and sleep problems for their children.


‘Researchers [also] controlled for prenatal stress, which may in some situations cause bias rather than controlling it.


Women reported taking paracetamol during pregnancy for a variety of reasons, including fever, infections, allergies, muscle aches, headaches, and trouble sleeping.


For Dr Ian Musgrave, a lecturer in pharmacology at the University of Adelaide, this represents a flaw in the study.


“A big problem in studies like these is the question of other conditions, mothers who took paracetamol took it for things like fever, infections and allergies, all of which can potentially affect a child’s mental development. ‘child,’ he said.


“For example, maternal stress was associated with child withdrawal, sleep and attention problems.


“The authors attempted to control for these confounders, but the association of paracetamol with sleep problems and attention problems after this correction is marginal and may simply be due to other factors associated with the need for use paracetamol for pain relief.”


Meanwhile, the study did not include the dosages of paracetamol taken, another problem according to Professor Pereira.


“The presence of a dose-response effect would lend greater credibility to the results,” he said.


“It would be more informative for doctors and patients to know the dose above which harm is most likely to occur.”


Other limitations noted by the study authors include the fact that the timing of paracetamol use during pregnancy was not recorded, while interviews with pregnant women were conducted at an average of 35 weeks of gestation, thus missing the last weeks of pregnancy.


Although the study has various limitations, it is not the first to raise concerns about pregnant women taking paracetamol.


Previous studies in 2018, 2019 and 2021 have also linked paracetamol use to ADHD and autism in children and the drug is known to cross the placental barrier.


However, for women with pain and fever during pregnancy, Dr. Musgrave says options are limited due to the known risks of NSAIDs and opiates on the fetus.


“There are few alternatives to paracetamol,” he said. ‘NSAIDs should not be used after 30 weeks of pregnancy due to rare kidney problems in children, pulmonary hypertension and premature closure of the ductus arteriosus, [while] chronic opioids should be used with caution to avoid withdrawal problems in the child at birth and the potential for addiction in the mother as well.


Dr Musgrave says that, as with any medicine, the ‘rule’ is to give the smallest amount for the shortest period of time needed to get relief.


“There have been suggestions from animal experiments, using much higher doses than would be used by humans, that paracetamol given during pregnancy could impact the mental development of the growing child. “, did he declare.


‘[But] Paracetamol is one of the few relatively safe medications for treating pain during pregnancy.


“As always, pregnant women should discuss any concerns with their doctor.”



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