Does prenatal acetaminophen use affect kids’ behavior ?

By Dr. Alan Kadish NMD

The JAMA Pediatric August 2016 study illustrated another association between ones use of tylenol® (acetaminophen) in the 2nd or 3rd trimester of a pregnancy and the results where youngsters at 7 year of age experienced higher levels of behavioral problems consisting of conduct disorders, emotional problems, and hyperactivity. 

This association is to be expected when we realize that the sensitivity to brain development is critical to having a fine balance with anti-0xidation enzymes. When we use acetaminophen it has an adverse effect on our production of glutathione, the principle antioxidant in our system. We don’t know if this is the full reason for the  changes in the kids, however it might be one of the mechanisms.

The real take home is that although there is less use of acetaminophen, since the FDA mandated reduced doses, in  prescription products since late 2011. We still encounter a fair amount of acetaminophen in many over the counter pain medications and combination products.

Check the labels of EVERYTHING you use as these studies do not reflect what amount is the problem. The caveat is less is better and none is the best approach,  especially if your pregnant, period.

This is but one of the many clearly problem medications to be avoided when contemplating or pregant.

Want to have a healthy pregnancy ? Call us at the Center of Health,  541.773.3191 and let’s get your internal and external environment as non-toxic as possible.

Link between risk of behavioral problems, use of drug

by Molly Walker Staff Writer, MedPage Today 

Prenatal exposure to acetaminophen was linked with a subsequent increased risk of behavioral problems in children, even after controlling for multiple confounders, a small cohort from a U.K. study found.

Maternal use of acetaminophen especially during the third trimester (32 weeks) was associated with a higher risk of conduct disorders, emotional problems, and problems with hyperactivity when children were 7 years old, reported Evie Stergiakouli, PhD, of University of Bristol in the U.K., and colleagues.

Notably, these associations remained, even after adjusting for a variety of confounders, including both maternal prenatal and postnatal acetaminophen use, as well as genetic factors — such as an index of ADHD genetic risk in mothers. Overall, 5% of children had behavioral problems.

[This] suggests that the association … is not explained by unmeasured familial factors linked to both acetaminophen use and childhood behavioral problems and that the findings are consistent with an intrauterine effect,” the researchers wrote. “Our results could have important implications for public health advice, which currently considers acetaminophen safe to use during pregnancy.”

Writing in JAMA Pediatrics, the authors analyzed data from the U.K. prospective birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), which enrolled 7,796 pregnant women from 1991 to 1992. Among those women 53% used acetaminophen during the third semester and 42% used the drug in the second semester.

The authors found that the risk of emotional and hyperactivity problems was also associated with acetaminophen use in the second trimester (18 weeks), though the risk was slightly lower than use of the drug in the third trimester.

Overall, maternal prenatal acetaminophen use in the third trimester was linked with an increased risk of several maternal-reported behavior problems in children from the Strengths and Difficulties Questionnaire, including:

  • 46% higher odds of “total difficulties” (RR 1.46, 95% CI 1.21-1.77)
  • 42% higher odds of conduct problems (RR 1.42, 95% CI 1.25-1.62)
  • 31% higher odds of hyperactivity symptoms (RR 1.31, 95% CI 1.16-1.49)
  • 29% higher odds of emotional problems (RR 1.29, 95% CI 1.09-1.53)

Second trimester use was linked with 23% higher odds of hyperactivity symptoms and 20% higher odds of conduct problems.

The authors argued that the timing of the drug might be important, with prior research also showing stronger associations between risk of behavioral problems and maternal acetaminophen use in the third trimester, as opposed to the second trimester.

“Given that there is active brain development and growth during the third trimester, this finding could indicate that there are developmental periods when the brain is more sensitive to acetaminophen exposure,” they wrote.

There are several hypotheses for the mechanisms surrounding the effect acetaminophen use may have on fetal neurodevelopment, including the endocrine-disrupting properties of the drug or the disruption of brain development through oxidative stress.

“Further studies are required to elucidate mechanisms behind this association as well as to test alternatives to a causal explanation,” the authors concluded.

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Dr. Kadish is an unusual physician often referred to as a "doctor detective". His expertise is the evaluation and treatment of complex disorders, typically after other physicians have been stumped, is renowned. He provides care for all family members and has additional training in autistic spectrum disorders and chronic complex diseases.