Taking acetaminophen during pregnancy is linked to sleep and attention problems in children

Taking acetaminophen during pregnancy is linked to sleep and attention problems in children

Acetaminophen use during pregnancy is associated with sleep and behavioral problems consistent with attention deficit hyperactivity disorder (ADHD), according to a study by researchers at Penn State College of Medicine.

Acetaminophen is a common medication used to treat a variety of problems, including fever, infections, muscle pain, headaches, migraines, colds, and allergies. Traditionally, the drug was considered safe by medical professionals for use during pregnancy. However, according to Kristin Sznajder, assistant professor of public health sciences and lead author, new studies support the idea that this drug may affect child development and be linked to attention problems.

Sznajder said her new study confirms these trends and is also the first to observe a link between acetaminophen use during pregnancy and sleep problems in children.

“Pregnant women experience pain, fever and other symptoms that could be relieved by taking acetaminophen,” said Sznajder, a researcher at the Huck Institute of the Life Sciences. "While the drug may provide temporary relief, research increasingly suggests that there may be downstream effects that could be detrimental to the child's development. Further research is needed so appropriate recommendations can be made to pregnant people."

Researchers used data from a study of more than 2,400 women who had never given birth before and followed them and their children from the third trimester of pregnancy until three years after birth. Women were asked once during their pregnancy about their medication use, frequency and stress levels. Of these, 41.7% of women reported taking paracetamol during pregnancy.

Participants were then interviewed 1, 6, 12, 18, 24, 30, and 36 months after the birth of their child. At the 36-month interview, participants were asked to rate their child using a three-point scale to describe how often he or she demonstrates a variety of neurodevelopmental and behavioral outcomes (very often true, somewhat true, or sometimes true and not true), such as “cannot sit still or be restless,” “avoids looking people in the eye,” and “does not want to sleep alone.” Scores were then taken for each behavior to determine whether the children scored well in the areas of emotionally reactive, anxious or depressed, withdrawn, sleep problems, and aggressive behavior.

Using responses from the 99-item child behavior checklist, researchers then assessed whether children of mothers who took acetaminophen during pregnancy were more likely to have attention, sleep or other neurobehavioral problems. Because women who took acetaminophen during pregnancy were more likely to be diagnosed with anxiety or depression before pregnancy and reported high levels of stress during pregnancy, the research team controlled for stress, depression during pregnancy, and previous diagnoses of depression or anxiety in their statistical analyses.

After accounting for confounding variables, children of women who took acetaminophen were significantly more likely to have sleep and attention problems than children of women who did not take acetaminophen during pregnancy.

The results confirm those of previous studies suggesting that taking paracetamol before birth could cause attention problems, while showing that sleep may also be affected. Of the women who took paracetamol during pregnancy, 22.7% reported that their child suffered from sleep problems and 32.9% described their child as suffering from attention problems. Of the participants who did not report taking acetaminophen during pregnancy, 18.9% reported that their child had sleep problems, while 28.0% reported that their child had attention problems. The results were published September 28 in PLOS One.

According to the study team, further research is needed to understand these relationships. Survey responses were missing data on trimester of use, frequency of use, and dosage amount. According to Sznajder, these are factors that could influence the result. She noted that a study is underway that will attempt to delve deeper into the trimester, frequency and dosage, and how this affects results. She also said that using a child development expert to assess children's behavior could help produce more accurate results.

According to the researchers, it is not clear which processes in prenatal development could be disrupted by prenatal use of paracetamol. However, they said some possibilities are that acetaminophen damages the placenta, thereby disrupting fetal development, or that acetaminophen damages the fetus' liver cells, which in turn affects gut health and impairs neurological development.

We should interpret these results with some caution. Although acetaminophen use is generally considered safe during pregnancy, data from several studies suggest that acetaminophen use may have effects on child development. It is important that we learn as much as we can about this topic so that we can provide expectant mothers with data-backed recommendations for the care of their children and themselves.”

Kristin Sznajder, lead author

Douglas Teti of Penn State College of Health and Human Development and Kristen Kjerulff of Penn State College of Medicine also contributed to this research. The researchers declare that there are no conflicts of interest related to this study. This research was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health.

Source:

Penn State College of Medicine

Reference:

Sznajder, KK, et al. (2022) Maternal use of paracetamol during pregnancy and neurobehavioral problems in offspring at 3 years of age: A prospective cohort study. PLUS ONE. doi.org/10.1371/journal.pone.0272593.

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