Children of women who used acetaminophen during pregnancy appear to be at higher risk of behavioral problems resembling attention-deficit/hyperactivity disorder and of hyperkinetic disorders, according to a study based in Denmark.
Acetaminophen is the most commonly used medication for pain and fever during pregnancy, according to background information in the study, which was published Feb. 24 on the website of JAMA Pediatrics. But some recent studies have suggested that acetaminophen has effects on sex and other hormones, which can in turn affect neurodevelopment and cause behavioral dysfunction.
Zeyan Liew, MPH, of the University of California, Los Angeles, and colleagues studied 64,322 children and mothers in the Danish National Birth Cohort (1996-2002). Parents reported behavioral problems on a questionnaire, and HKD diagnoses and ADHD medication prescriptions were collected from Danish registries.
More than half the mothers reported using acetaminophen while pregnant. The use of acetaminophen during pregnancy appeared to be associated with a higher risk of HKD diagnosis, of using ADHD medications or of having ADHD-like behaviors at age 7. The risk increased when mothers used acetaminophen in more than one trimester during pregnancy.
Maternal acetaminophen use during pregnancy is associated with a higher risk for HKDs and ADHD-like behaviors in children, the authors wrote. Because the exposure and outcomes are frequent, these results are of public health relevance but further investigations are needed.
In an accompanying editorial, Miriam Cooper, MRCPsych, MSc, of Cardiff University School of Medicine in Wales, and colleagues wrote: Causation cannot be inferred from the present observed associations, and Liew et al are right to point out that a replication of their study is needed.
In summary, findings from this study should be interpreted cautiously and should not change practice. However, they underline the importance of not taking a drugs safety during pregnancy for granted, and they provide a platform from which to conducted further related analyses exploring a potential relationship between acetaminophen use and altered neurodevelopment.
Study abstract: http://archpedi.jamanetwork.com/article.aspx?articleid=1833486