Paracetamol and pregnancy, a new study links the impact of the drug on sleep and attention of children at three years

Paracetamol

is one of the most used drugs during pregnancy worldwide.

Various recent studies have established associations between

to this drug and

in children, including

.

However, there is

or the possible confounding effects of prenatal stress.

Therefore, the purpose of the latest study published in Plos One was to examine the association between prenatal acetaminophen exposure and offspring neurobehavioral problems at the age of three.

From the SMC,

director of the BCNatal maternal-fetal medicine center (Hospital Clínic-Sant Joan de Déu) and professor at the University of Barcelona, ​​believes that the study "is of quality, but like most of these studies it is limited, being based on a database that, although it is of quality, was not designed to accurately evaluate the objective of the study.For this reason, the conclusions, although valid and relevant, must be contextualized, especially in the sense that it is not possible to rule out confounding factors that can explain the observed association.A very clear example is that when the authors adjust for maternal stress, some associations are lost, and this shows how complex it is to evaluate associations between consumption in pregnancy and a subsequent outcome,something that can only be established with some certainty in studies that are randomized clinical trials and specifically designed to answer the research question".

The study fits with previous evidence and, therefore, it is plausible that there is a (weak) association between the use of paracetamol and (mild) neurodevelopmental alterations.

It does not provide more news beyond the fact that it is a somewhat larger study, but it coincides with previous studies along the same lines.

The team led by

, from the Department of Public Health Sciences, Penn State University School of Medicine, USA, evaluated a significant volume of participants (

) and completed a stress questionnaire prenatal.

Through follow-up,

and the children of mothers who did not take acetaminophen were compared with those of mothers who did.

Gavin Pereira

, Researcher in Epidemiology and Biostatistics at the Curtin School of Population Health at Curtin University and Director of the Child and Family Health Program at the enAble Institute (Australia), told SMC Australia, "it

In the US study, these outcomes were assessed by the mothers, rather than by a relatively more independent party, such as a teacher or doctor. mothers with underlying anxiety are more likely to take acetaminophen and report these negative outcomes for their children, whether or not there is an underlying biological effect."

For his part,

, Professor of Pharmacology at the Faculty of Medicine of the School of Medical Sciences, at the University of Adelaide (Australia), as reported by SMC Australia, states that "

Pain itself, and the reasons for it, can be a potential source of harm to both the mother and the developing child

. The safety of our medicines is constantly being reassessed and acetaminophen is no exception."

Both experts question the direct relationship, that is, cause and effect of the use of this medication during pregnancy.

"A big problem in this type of study is the existence of other disorders:

(what is called confounding factors).

For example, maternal stress was associated with the child being withdrawn, having sleep and attention problems.

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

The current findings

that found links between prenatal acetaminophen exposure and attention problems in offspring and, at the same time, show

.

Because the use of acetaminophen during pregnancy is common, these results are a cause for concern from a public health point of view and suggest caution in the use of acetaminophen-containing medications during pregnancy.

As Musgrave explains, "Animal experiments, using doses much higher than those used in humans, have suggested that acetaminophen given during pregnancy might affect the mental development of the growing child.

."

Risk-benefit balance, paracetamol yes

For this reason, for the time being, they remain in favor of continuing to use this drug, because there are more benefits than risks.

"

The results of this study certainly do not imply that common alternatives, such as nonsteroidal anti-inflammatory drugs (NSAIDs), should be used for pain relief in pregnancy instead of paracetamol.

," says Pereira.

To which Musgrave adds that "with this new study,

. As always, pregnant women should discuss any concerns with their physicians.

to achieve relief.

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