Taking paracetamol during pregnancy is linked to autism and
ADHD in children, a new study claims. Boys whose mothers took the painkiller
while expecting were more likely to be on the autistic spectrum while it
was associated with higher rates of ADHD in both sexes.
Official guidelines say paracetamol should be taken only if
necessary in pregnancy and for the shortest possible time. The latest study by
Spanish researchers suggests children regularly exposed to the common
medication while in the womb were more likely to show signs of both conditions.
In what has been hailed the first study of its kind, it
looks at the association between the use of this drug in pregnancy and autism
spectrum symptoms in children. Scientists say it is also the first study to
report different effects on boys and girls.
They found those whose mothers took the drug regularly were
30 per cent more likely to show impaired attention functions and an
increase of two clinical symptoms of autism spectrum symptoms in boys.
The study recruited 2,644 mother-child pairs in a birth
cohort study during pregnancy.
Of these, 88 per cent were evaluated when the child was one
year old, and 79.9 per cent were evaluated when they were five years old.
Mothers were asked about their use of paracetamol during
pregnancy and the frequency of use was classified as never, sporadic, or
persistent.
Exact doses taken could not be noted as the mothers were
unable to recall them precisely.
It found 43 per cent of children evaluated at age one and 41
per cent assessed at age five were exposed to any paracetamol at some point
during the first 32 weeks of pregnancy.
When they were again assessed at age five, exposed children
were at higher risk of hyperactivity or impulsivity symptoms.
Persistently exposed children in particular showed poorer performance on a computerised test measuring inattention, impulsivity and visual speed processing, the study found.
Boys also showed more autism spectrum symptoms when
persistently exposed to paracetamol.
Lead author Claudia Avella-Garcia, researcher at CREAL, part
of the Barcelona Institute for Global Health, explained they tested for
symptoms rather than exact diagnoses.
'Although we measured symptoms and not diagnoses, an
increase in the number of symptoms that a child has, can affect him or her,
even if they are not severe enough to warrant a clinical diagnosis of a
neurodevelopmental disorder.'
Co-author Dr Jordi Júlvez, said there were several reasons
why paracetamol could be harmful to neurodevelopment.
'First of all, it relieves pain by acting on cannabinoid
receptors in the brain.
'Since these receptors normally help determine how neurons
mature and connect with one another, paracetamol could alter these important
processes,' he said.
'It can also affect the development of the immune system, or
be directly toxic to some fetuses that may not have the same capacity as an
adult to metabolize this drug, or by creating oxidative stress.'
There could also be an explanation for why boys are more likely to have autism spectrum symptoms, Professor Garcia said.
'The male brain may be more vulnerable to harmful influences
during early life', she said.
The study concluded that the widespread exposure of infants
to paracetamol in the womb could increase the number of children with ADHD or
autism spectrum symptoms.
However, they stressed further studies should be conducted
with more precise dosage measurements, and that the risks versus benefits of
paracetamol use during pregnancy and early life should be assessed before
treatment recommendations are made.
The findings were published this week in the International
Journal of Epidemiology.
Commenting on the study, Professor Alan Cameron, of the Royal College of Obstetricians and Gynaecologists, said: 'Paracetamol is one of the most common medicines used to reduce a high temperature and ease pain, it is safe and is used routinely during all stages of pregnancy.
The preliminary results from this study suggest that
frequent paracetamol use throughout pregnancy may impact attention function and
slightly increase the risk of hyperactivity in the offspring at aged 5 years
old.
'No effect on cognitive, motor or social development was
identified.'
He added: 'It is important to highlight from these results
we cannot determine a direct link between paracetamol usage and any
neurodevelopmental problems.
'Future studies should take into account dosage as well as
other possible contributory factors. However, women should not be alarmed by
the results of this study and we recommend that pregnant women continue to
follow current guidance and take the lowest effective dose for the shortest
possible time when necessary.
'If the recommended dose of paracetamol doesn't control
symptoms or pain, seek advice from your midwife, GP or obstetrician.'
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