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Paracetamol pregnancy risk findings challenged

American television pundit John Oliver once said: “not all scientific studies are equal …some … may be subtly biased because of scientists being pressured to come up with eye-catching positive results.”

This may, unfortunately, be the case with a recent study on pregnant women’s use of paracetamol, which found that their usage was linked to behavioural problems in children.

The study was published by the American Medical Association journal JAMA Pediatrics. The UK-based authors examined nearly 8000 mothers. In their article, “Association of Acetaminophen Use During Pregnancy With Behavioral Problems in Childhood”, they reported that prenatal use of paracetamol by mothers at 18 and 32 weeks of pregnancy was associated with increased risk of conduct problems and hyperactivity symptoms in children, and maternal paracetamol use at 32 weeks of pregnancy also was associated with higher risk for emotional symptoms and total difficulties in children. Their emphatic conclusion? “Children exposed to acetaminophen [paracetamol] prenatally are at increased risk of multiple behavioural difficulties.”

Although the authors acknowledged that “further studies are required to replicate the findings”, in the hands of ‘click-bait’ media, this message can be distorted, if not disregarded entirely.

Norman Saunders, professorial fellow in neuroscience at the University of Melbourne, is determined to set the media’s paracetamol record straight. In examining the research more closely, he noted that behavioural problems were detected in only 5 per cent of children who were prenatally exposed to paracetamol.

He also explained that, aside from paracetamol, other, untested variables may have caused children’s behavioural issues, for example, the underlying illness that caused these women to take paracetamol could be to blame. While the researchers attempted to account for this by factoring participants’ self-reported illness into the study’s results, Saunders claimed this is an unreliable form of data-gathering.

For these reasons, Saunders contended that the authors’ conclusion was “not established” by the data.

Dr Luke Grzeskowiak, NHMRC early-career research fellow at the Robinson Research Institute, University of Adelaide, holds a similar opinion. “Further studies are still needed before we jump to changing clinical practice recommendations”, he cautioned. “Paracetamol is useful in treating fever and different types of pain and it still remains our first choice for treating these conditions during pregnancy.”

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