ADHD and autism: be careful about taking paracetamol during pregnancy

“Pregnant, medication is not just any old thing!” proclaims the first information campaign of the Health Agency for Medicines Safety (ANSM) which started on June 2, 2021. This is exactly the message to be taken from a large international study showing that consuming paracetamol (also known as acetaminophen) during pregnancy increases the risk of developing attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in children.

Nearly one in two pregnant women uses paracetamol

The link was certainly already known but it has just been confirmed by a solid international study published in European Journal of epidemiology. A team of pediatricians from the Barcelona Institute for Global Health (ISGlobal) indeed confirms this association already found in the past but here on a very large sample grouping together different European cohorts.

It is estimated today that nearly one in two women during her pregnancy resort to the use of this molecule both analgesic and antipyretic (which fights fever).

A risk increased by 20%

In this new study, the analysis of exposure data in utero of 73,881 European children enrolled in six European cohorts – via questionnaires sent to mothers retrospectively – made it possible to quantify at 20% the increase in the risk of ADHD or ASD in the event of prenatal exposure to paracetamol.

Pediatricians have also been interested in postnatal exposure but this does not seem to induce any increase in the risk of neurological disorder. However, new research should be continued.

In summary, the main author of this work, Dr Sílvia Alemany of the Pompeu Fabra University (Barcelona), specifies that “given the links between the use of acetaminophen and neurodevelopment, acetaminophen should not be removed in pregnant women or children, but should only be used when necessary “. A work that confirms the call for vigilance emanating from another study published at the end of 2019 in the journal Jama Psychiatry.

What are the mechanisms at work?

It now remains to decipher the precise pharmacological mechanisms. Already, hypotheses are circulating such as the stimulation of the endocannabinoid system (a set of cell receptors and molecules) or the change in the level of neurotrophic factor (growth factor active on neurons).

It should be remembered that occasional uses at the right dosages are not to be demonized, however. Beyond the key national campaign message, four rGolden rules should be kept in mind for pregnant women:

  • prepare for pregnancy with your doctor or midwife
  • do not self-medicate
  • do not stop treatment on your own
  • inform all health professionals consulted

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