Study: paracetamol and the risk of behavioral problems in children

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Reference Stergiakouli E., Thapar A., ​​Davey Smith Gd. Association of paracetamol intake during pregnancy with behavioral problems in childhood: evidence against confusion. Jama Pädiatr. 2016; 170 (10): 964-970. Design retrospective analysis of a prospective birth cohort, the Avon Longitudinal Study of Parents and Children (Alspac) participants collected the investigators and analyzed data from 7,796 mothers, which were enrolled in the Alspac between April 1991 and December 1992. The data contained information about the children and partners of the mothers. Study target to determine whether a connection between the child's behavioral problems and the use of paracetamol by the mother or partner during or after pregnancy there is target parameters ...
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Reference

stergiakouli E., Thapar A., ​​Davey Smith Gd. Association of paracetamol intake during pregnancy with behavioral problems in childhood: evidence against confusion. Jama Pädiatr. 2016; 170 (10): 964-970.

Design

retrospective analysis of a prospective birth cohort, the Avon Longitudinal Study of Parents and Children (Alspac)

participant

The investigators collected and analyzed data from 7,796 mothers who were enrolled in the Alspac between April 1991 and December 1992. The data contained information about the children and partners of the mothers.

Study goal

to determine whether there is a connection between the child's behavioral problems and the use of paracetamol by the mother or partner during or after pregnancy

target parameter

The participants of the Alspac study filled a questionnaire for the use of paracetamol (paracetamol; brand name Tylenol) in the 18th and 32nd week of pregnancy and then again at the age of 61 months. When the children were 7 years old, maternal reports of behavioral problems were collected and evaluated with the help of the Strengths and diffulties Questionnaire (SDQ). The SDQ contains 5 areas: emotional symptoms, behavioral problems, hyperactivity symptoms, problems in relationship with peers and prosocial behavior.

important knowledge

of the 7,796 mothers recorded stated that they had taken paracetamol in the 18th week and 42 % in the 32nd week. The prenatal application of paracetamol in the 18th and 32nd week of pregnancy was associated with a 20 % higher probability that the child had behavioral problems (risk relationship [RR]: 1.20; 95 % confidence interval [CI]: 1.06–1.37) and a 23 % higher probability of hyperactivity symptoms (RR: 1.23; 95 % KI: 1.08–1.39). The use of paracetamol by the mother after 32 weeks was associated with a 29 % higher probability that the child had emotional symptoms (RR: 1.29; 95 %-KI: 1.09–1.53), a 42 % higher probability of behavioral problems (RR: 1.42; 95 % KI: 1.25–1,62), 31 % higher for Hyperactivity symptoms (RR: 1.31; 95 %-KI: 1.16–1.49) and 46 %higher probability for comprehensive difficulties (RR: 1.46; 95 %-KI: 1.21–1.77) in accordance with SDQ. The absolute percentage of children with behavioral problems, defined by the domain "comprehensive" on the SDQ, was 5 %.
There was no connection between the postnatal paracetamol consumption of the mother or paracetamol consumption of the partner and the behavioral values ​​in SDQ.
The researchers conclude: “Children who are exposed to prenatal paracetamol have an increased risk of multiple behavioral disorders, and the associations do not seem to be declared by non-measured behavior or social factors in connection with paracetamol consumption, since they are not observed for post-natal paracetamol consumption . “

practice implications

This latest study is in accordance with previous research results that show a connection between the taking of paracetamol during pregnancy and the development of symptoms of a attention deficit hyperactivity disorder (ADHD).
These new data complement the growing number of research results that illustrate the many dangers of this frequently used over -the -counter drug (OTC). It is generally known that paracetamol can damage the liver. In fact, it is the main cause of acute liver failure in the United States and in the United Kingdom. 4.5 acetamineophs reduces the liver memory of the important detoxification helper and antioxidant glutathione. It is advisable to use it.
Even after birth, the use of paracetamol can be problematic for the child. Paracetamol is often the medication of choice to relieve fever in children. However, the application against fever in the first year of life is associated with an increase in the incidence of asthma and other allergic symptoms in later childhood. 8 asthma is another disease process that is strongly influenced by antioxidant mechanisms. strongly reduced, it should not be used in children with asthma.
These new data complement the growing number of research results that illustrate the many dangers of this frequently used over -the -counter drug (OTC).
Early research in connection with this latest study makes it clear that clinicians should warn patients of the dangers associated with the use of paracetamol, especially in certain population groups such as pregnant women and children. The studies that indicate an increased risk of ADHD symptoms in children of mothers who take the medication during pregnancy should be emphasized in clinical practice.
According to the Centers for Disease Control and Prevention, the number of ADHD cases from 7.8 % in 2003 to 11 % increased significantly. Everything that clinicists can do to reduce the number of children with this diagnosis will certainly lead to an improvement in the quality of life of their patients. Advising pregnant mothers on alternatives to paracetamol is a step in the right direction.
A natural substance that represents a useful alternative for pregnant women is ginger ( zingiber officinale ). Several double-blind studies have shown the advantages of ginger in a variety of gastrointestinal problems, especially in the event of nausea and vomiting, including severe morning nausea. 11 In addition, dozens of clinical studies have its use to relieve pain and inflammation in various forms of arthritis, chronic back pain, muscle pain and painful menstruation supported.
It is unfortunate that paracetamol has become such a popular OTC medication due to its side effects. In 2013 alone, turnover with Tylenol exceeded $ 200 million for adults, and sales with Tylenol for children (liquid) rose to over $ 51 million. 14 While people are reasonably programmed to reach for paracetamol, it is up to the doctors to inform them about the risks that are associated with their use, especially in the case of pregnant women and their descendants.

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