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Prenatal Acetaminophen Use & Childhood Behavior Problems
JAMA Pediatr; ePub 2016 Aug 15; Stergiakouli, et al
There is increased risk of multiple behavioral difficulties among children exposed to acetaminophen prenatally, a recent study found. Researchers studied 7,796 mothers enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) between 1991 and 1992 along with their children and partners and analyzed data from February 2015 to March 2016. Acetaminophen use was assessed at 18 and 32 weeks of pregnancy and when the child was 61 months old. They found:
• There were higher odds of having conduct problems (RR, 1.42) and hyperactivity symptoms (RR, 1.31) with maternal prenatal acetaminophen use at 18 (n=4,415) and 32 weeks of pregnancy (n=3,381).
• Maternal acetaminophen use at 32 weeks was also associated with higher odds of having emotional symptoms (RR, 1.29) and total difficulties (RR, 1.46).
• Maternal postnatal (n=6,916) or partner’s (n=3,454) acetaminophen use did not reveal these behavioral difficulties.
Stergiakouli E, Thapar A, Smith GD. Association of acetaminophen use during pregnancy with behavioral problems in childhood. [Published online ahead of print August 15, 2016]. JAMA Pediatr. doi:10.1001/jamapediatrics.2016.1775.
Over half of pregnant women in the US use acetaminophen at some point during their pregnancy.1 A relative risk increase of 1.3 to 1.5 means that there may be approximately a 30 to 50% increase in the risk of conduct, hyperactivity or emotional problems in the children of the large number of women who take acetaminophen during pregnancy. While other studies have suggested this association, this study accounted for potential confounding variables by looking at acetaminophen postnatal exposure and partner use as well, finding no association in those groups. Treatment of pain during pregnancy is difficult and important, and this data make such treatment even more challenging. —Neil Skolnik, MD