A study has found that a mother’s use of paracetamol during pregnancy is associated with symptoms of ADHD and autism in children.
Researchers at the Barcelona Institute for Global Health (ISGlobal) have determined that symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum conditions (ASC) are connected to the use of paracetamol during pregnancy.
The results of the epidemiological study, which analysed over 70,000 children in six European cohorts, have been published in the European Journal of Epidemiology.
The researchers looked at data for 73,881 children, containing details of prenatal or postnatal exposure to paracetamol, at least one symptom of ASC or ADHD, and main covariates. Depending on the cohort, 14% to 56% of the mothers reported taking paracetamol while pregnant.
The study found that children exposed to paracetamol before birth were 19% more likely to develop ASC symptoms and 21% more likely to develop ADHD symptoms than children who were not exposed.
Current guidelines and past research
NHS advice currently is that paracetamol is safe to take during pregnancy and when breastfeeding.
Sílvia Alemany, lead author of the study and ISGlobal researcher, explained: “Our findings are consistent with previous research. We also found that prenatal exposure to paracetamol affects boys and girls in a similar way, as we observed practically no differences.”
Jordi Sunyer, researcher at ISGlobal and last author of the study, added: “Our results address some of the weaknesses of previous meta-analyses.
“Considering all the evidence on the use of paracetamol and neurological development, we agree with previous recommendations indicating that while paracetamol should not be suppressed in pregnant women or children, it should be used only when necessary.”
At some stage during pregnancy, an estimated 46% to 56% of pregnant women in developed countries use paracetamol, which is considered the safest analgesic/antipyretic for pregnant women and children. However, mounting evidence has linked prenatal paracetamol exposure to poorer cognitive performance, more behavioural problems, and ASC and ADHD symptoms.
Those previous studies have been criticised for their heterogeneity.
In the new study, therefore, “an effort was made to harmonise the assessment of ADHD and ASC symptoms and the definition of paracetamol exposure,” explained Alemany.
“The sample is large,” she added, “and it includes cohorts from multiple European countries: the United Kingdom, Denmark, the Netherlands, Italy, Greece, and Spain. We also used the same criteria for all of the cohorts, thereby reducing the heterogeneity of criteria that has hampered previous studies.”
Conclusions and future thoughts
The study also analysed postnatal exposure to paracetamol and found no association between paracetamol use during childhood and ASC symptoms. Nevertheless, the research team concluded that further studies are needed, given the heterogeneity of postnatal paracetamol exposure among the various cohorts, which ranged from 6% to 92.8%.