More research on acetaminophen during pregnancy and subsequent ADHD

During pregnancy the prescription drugs, painkillers, and supplements a woman is on may change to keep the growing fetus safe. One of the most scrutinized is acetaminophen, with research in a number of areas. An investigation in JAMA Pediatrics adds more research on exposure to acetaminophen in utero and attention-deficit/hyperactivity disorder (ADHD).¹

Researchers ran a prospective birth cohort study at the Centre Hospitalier Université de Sherbrooke in Sherbrooke, Québec, Canada. The mothers were enrolled from September 2007 to September 2009 at the time of either the first prenatal care visit or delivery. Meconium samples were acquired at the time of the child’s delivery. When the child was aged 9 to 11 years, magnetic resonance imaging was used to assess resting-state brain connectivity. The Behavioral Assessment System for Children Parent Report Scale was used to determine hyperactivity and attention problems.

There were 345 children who were included in the study. Acetaminophen was found in 199 samples of meconium and ADHD was diagnosed in 33 children in the sample. When compared with no acetaminophen, the detection of acetaminophen in meconium was linked to increased odds of ADHD (odds ratio [OR], 2.43; 95% CI, 1.41-4.21). Additionally, the researchers detected a dose-response association with each doubling of exposure increasing the odds of ADHD by 10% (OR, 1.10; 95% CI, 1.02-1.19). The children who had acetaminophen detected in their meconium sample had increased negative connectivity between frontoparietal and default mode network nodes to clusters in the sensorimotor cortices, which facilitated an indirect effect on increased child hyperactivity (14%; 95% CI, 1%-26%).

Investigators concluded that the study adds more information regarding the impact of prenatal acetaminophen exposure on adverse development. The findings suggest once more that caution should be taken when considering acetaminophen for pain relief during pregnancy. The investigators also urged further research into alternative pain management strategies for pregnant women to reduce the use of acetaminophen for pain relief.

Reference

1. Baker B, Lugo-Candelas C, Wu H, et al. Association of prenatal acetaminophen exposure measured in meconium with risk of attention-deficit/hyperactivity disorder mediated by frontoparietal network brain connectivity. JAMA Pediatr. September 28, 2020. Epub ahead of print. doi:10.1001/jamapediatrics.2020.3080