Common Painkillers During Pregnancy Linked to Increased Risk of ADHD in Children

Children who used paracetamol, also known as acetaminophen, during their mother’s pregnancy, are more likely to develop ADHD than those whose mothers do not, suggesting small studies. Although inconclusive, this finding gives weight to the contested idea that widely used painkillers can affect fetal brain development.

Previous studies on paracetamol and neurodevelopmental conditions provide conflicting findings. For example, a 2019 study linking over 4,700 children and their mothers with their mothers to use painkillers during pregnancy There is a 20% higher risk Children developing ADHD. However, the analysis presented by nearly 2.5 million children last year There is no such connection When comparing siblings who were exposed or not to paracetamol before birth.

One problem is that most of these studies rely on self-reported medication use. This is a serious limitation as you may not remember taking paracetamol during pregnancy. For example, only 7% of participants in the 2019 study reported using paracetamol during pregnancy. It's well below the 50% seen in other studies. “A lot of people take it [paracetamol] Without knowing that” Brennan Baker At Washington University in Seattle. “It could be the active ingredient in some of the cold medicines you're using, and you don't necessarily know.”

So Baker and his colleagues used more accurate metrics instead. They looked for medication markers in blood samples collected from 307 women. They were all black and lived in Tennessee in the late pregnancy. None of them were taking medication due to chronic illnesses and were unaware of the complications of pregnancy. The researchers then followed up with participants when the child was 8 to 10 years old. In the US, Approximately 8% of children I have ADHD between the ages of 5 and 11.

On average, children whose mothers had a marker of paracetamol in their blood were three times more likely than children born to mothers, even after adjusting for factors such as mother's age and body mass index before pregnancy. There was a possibility (BMI), mental health status among close relatives of socioeconomic status and mental health. This suggests that using paracetamol during pregnancy may increase the risk of developing ADHD in children.

However, it is also possible that the actual factor that increases your risk of ADHD is not the drug itself, but the first thing you will be taking paracetamol. “They couldn't explain anything like the reason why their mother took it. [paracetamol]”It has been found to be risk factors for adverse development in children, such as headaches, fever, pain and infectious diseases.” Viktor Ahlqvist At the Karolinska Institute in Sweden.

But Baker believes that it is the drugs that are responsible. Subsequent analysis of tissue samples from 174 of participants' placenta showed that people using paracetamol have different metabolic and immune system changes. These changes are similar to those seen in studies testing the effects of paracetamol in pregnant animals without infection or underlying health conditions.

“I think the fact that we see immune upregulation in animal models also really strengthens the causal case,” Baker says. “There are many previous studies showing that elevated immune activation during pregnancy is linked to adverse neurodevelopment.”

Yet these findings are far from conclusive. For one thing, the study included a small number of participants, all black and lived in the same city, limiting the generalization of the findings. Another case, it measured only the blood markers of paracetamol at one moment. These markers have stuck for about three days, so the study probably captured more frequent users, and may have a dose-dependent effect, says Baker.

“[Paracetamol] Now is the first-line treatment option for pain and fever during pregnancy,” says Baker. “But I think I'm an agency [US Food and Drug Administration] In addition, various obstetric and gynecological associations should continuously review all available research and update their guidance. ”

Meanwhile, if it's unclear whether to take paracetamol during pregnancy, people should talk to their doctor, Baker says.