Tuesday, February 25, 2014

Acetaminophen Use During Pregnancy Linked to ADHD in Offspring, Study Suggests

Use by mothers of acetaminophen during pregnancy may increase the risk of ADHD and hyperkinetic disorders (HKDs), according to a report in JAMA Pediatrics.

Researchers at the University of California and other institutions prospectively assessed acetaminophen use during pregnancy via three computer-assisted telephone interviews during pregnancy and 6 months after child birth. They studied 64 322 live-born children and mothers enrolled in the Danish National Birth Cohort during 1996-2002.

They used parental reports of behavioral problems in children 7 years of age using the Strengths and Difficulties Questionnaire; retrieved HKD diagnoses from the Danish National Hospital Registry or the Danish Psychiatric Central Registry prior to 2011; and identified ADHD prescriptions for children from the Danish Prescription Registry. They then estimated hazard ratios for receiving an HKD diagnosis or using ADHD medications and risk ratios for behavioral problems in children after prenatal exposure to acetaminophen.

Children whose mothers used acetaminophen during pregnancy were at higher risk for receiving a hospital diagnosis of HKD, use of ADHD medications, or having ADHD-like behaviors at age 7 years. Stronger associations were observed with use in more than 1 trimester during pregnancy, and exposure response trends were found with increasing frequency of acetaminophen use during gestation for all outcomes.

Child psychiatrist David Fassler, M.D., called the report intriguing. "The findings demonstrate an increased incidence of ADHD by age 7 in children whose mothers took acetaminophen during pregnancy," he told Psychiatric News. "The association persists after controlling for factors such as maternal fevers, infections and inflammation. The authors speculate that acetaminophen may have an impact on hormone levels during critical periods of fetal brain development. Although an intriguing hypothesis, further research will clearly be needed both to replicate the current findings and to establish a definitive causal relationship between prenatal exposure to acetaminophen and ADHD. However, the current results underscore the importance of avoiding unnecessary exposure to all medications, including acetaminophen, during pregnancy."

For more information on ADHD see the Psychiatric News article, "Addressing Comorbid ADHD, Substance Abuse Disorder in Adolescents."

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