acetaminophen use during preg and adhd....
acetamenophen use in pregnancy may be linked to ADHD
- Children whose mothers took acetaminophen were more likely to develop
- The association does not prove acetaminophen causes ADHD
- Women should be cautious about using any medication in pregnancy,
Acetaminophen, the most common drug taken by pregnant women, may be linked
to attention deficit hyperactivity disorder (ADHD) in children, according
to a large but preliminary new study from Denmark.
The study, published Monday in *JAMA Pediatrics*, found the disorder was
more likely to develop in children whose mothers took the medication while
Experts say the study does not prove a cause-and-effect relationship and
more study is needed. It is likely to prompt concerns among women who have
been told that the medication - found in Tylenol and many other pain and
fever remedies - is safe during pregnancy.
The study is a reminder that “anything we do in pregnancy we should not do
lightly,” says one study author, Beate Ritz, an epidemiologist at the
University of California-Los Angeles. She worked with researchers from the
University of Aarhus in Denmark and other institutions.
The researchers looked for a link between acetaminophen and ADHD because
they believe the medication might work as a hormone disruptor capable of
affecting fetal brain development, Ritz says.
The study included more than 64,000 Danish children born from 1996 to 2002.
The mothers of those children were called twice during pregnancy and once
six months after birth and asked about painkiller use.
Thanks to thorough health records available in Denmark, the researchers
were able to track children in three ways: through questionnaires on
development parents completed when children were 7 years old; through
diagnoses of “hyperkinetic disorder”; and through prescriptions for ADHD
medications such as Ritalin.
Children whose mothers took acetaminophen were:
*13% more likely to show ADHD-like behaviors, such as hyperactivity and
*37% more likely to be diagnosed with hyperkinetic disorder, which is the
equivalent of “high end” ADHD, Ritz says.
*29% more likely to get ADHD medications.
The associations held up even when researchers considered mothers’ mental
health histories and additional factors - including fevers, infections and
inflammation—that might have led women to take acetaminophen in the first
place. The associations grew stronger the more weeks mothers reported
taking acetaminophen, Ritz says. She says one flaw of the study is that
researchers don’t know how many pills women took.
Researchers cannot rule out that some unreported condition more common
among women who took a lot of acetaminophen - for example, a genetic
tendency to be highly sensitive to pain - might be the real link to ADHD,
The study “should be interpreted cautiously and should not change
practice,” says an accompanying editorial written by psychiatric researcher
Miriam Cooper and colleagues at Cardiff University in the United Kingdom.
But the findings “underline the importance of not taking a drug’s safety
during pregnancy for granted,” they wrote.
Though the study is well done, “it’s a big jump to go from an association
to a cause-and-effect relationship,” says Jeff Chapa, director of maternal
fetal medicine at Cleveland Clinic.
Chapa, who was not involved in the research, says it’s important that
worried pregnant women not use ibuprofen and other non-steroidal
anti-inflammatory drugs (NSAIDS) as substitutes for acetaminophen. NSAIDS
can disrupt fetal development and cause other problems, he says.
Pregnant women with a fever should still take acetaminophen to reduce it,
he says, because fevers might affect fetal development. But there’s good
reason to be conservative about using it for aches and pains when a warm
bath, a massage or some stretching might provide relief, he says. When
women find themselves using acetaminophen repeatedly, he says, they should
consult their obstetricians.
“We really should start looking at non-pharmacological ways to deal with
pain,” Chapa says.
About 56% of women in the Danish study used acetaminophen during pregnancy.
Usage is similar in the USA.
About 11% of U.S. children ages 4 to 17 had been diagnosed with ADHD as of
2011, according the federal Centers for Disease Control and Prevention.
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