Acetaminophen Use in Pregnancy Linked to ADHD in Kids

Summary: Researchers found a connection between the increased use of acetaminophen during pregnancy, particularly in the second trimester, and attention and behavior problems in young children. The research, part of the Illinois Kids Development Study, involved tracking prenatal chemical exposures and assessing the behaviors and traits of children at ages 2, 3, and 4.

While acetaminophen is deemed the safest painkiller during pregnancy, the study reveals a trend where higher usage, especially in the second trimester, corresponds to more attention-related problems and ADHD-type behaviors in children. However, the study’s authors emphasize the need for more research and caution against interpreting the findings as an indication of ADHD or other disorders.

Key Facts:

  1. The study links frequent acetaminophen use in pregnancy, especially in the second trimester, to attention problems in children.
  2. Over 300 children were assessed, showing a trend of more attention-related and externalizing behaviors with increased acetaminophen exposure.
  3. This research adds to existing concerns about acetaminophen’s impact on child development, yet more studies are needed for conclusive evidence.

Source: University of Illinois

A new study links increased use of acetaminophen during pregnancy – particularly in the second trimester – to modest but noticeable increases in problems with attention and behavior in 2-, 3- and 4-year-olds.

The study adds to a growing body of evidence linking the frequent use of acetaminophen in pregnancy to developmental problems in offspring.

The findings are detailed in the journal Neurotoxicology and Teratology.

This shows a pregnant woman.
The researchers also asked caregivers to answer dozens of standardized questions about their child’s behavior and ability to pay attention at ages 2, 3 and 4. Credit: Neuroscience News

The research is part of the Illinois Kids Development Study at the University of Illinois Urbana-Champaign, which explores how environmental exposures influence child development. The study tracked hundreds of children, collecting data on their prenatal chemical exposures and asking caregivers to assess their behaviors and traits at ages 2, 3 and 4.

While acetaminophen is considered the safest painkiller and fever reducer available during pregnancy, previous studies have found evidence of a range of possible negative outcomes for children exposed to the drug in gestation, said Megan Woodbury, who led the research as a graduate student at the U. of I. with comparative biosciences professor emerita Susan Schantz, the principal investigator of the IKIDS program at Illinois. Woodbury is now a postdoctoral researcher at Northeastern University in Boston. Schantz is a faculty member of the Beckman Institute for Advanced Science and Technology at the U. of I.

A recent study led by Woodbury and Schantz linked higher acetaminophen exposure in pregnancy to language delays in children.

Some previous studies have found no relationship between acetaminophen use in pregnancy and attention and behavior in childhood, while other, usually larger studies found relationships between more frequent use of the medication during pregnancy and attention-related and behavioral problems in offspring.

Most of the latter studies were conducted in older children and questioned pregnant participants about their use of acetaminophen at most once per trimester.

The new study asked pregnant parents about their acetaminophen use six times over the course of the pregnancy – roughly once every four-to-six weeks – offering a more precise picture of the magnitude and timing of the drug exposures.

The researchers also asked caregivers to answer dozens of standardized questions about their child’s behavior and ability to pay attention at ages 2, 3 and 4. More than 300 children were assessed at age 2, with 262 assessed again at 3, and 196 at age 4.

“Our most important finding was that with increasing acetaminophen use by pregnant participants, especially during the second trimester, their children showed more attention-related problems and ADHD-type behaviors, which we call ‘externalizing behaviors,’ at every age we measured,” Woodbury said.

“The kinds of behaviors the caregivers reported included things like the child talking out of turn, not paying attention, not being quiet when they were supposed to be quiet, not sitting down when they were supposed to be sitting down, and being a little aggressive with other children,” Schantz said.

The findings are not an indication that the children have attention-deficit/hyperactivity disorder or that they will be diagnosed with ADHD at a later date, Schantz said. But the children seem to be having more trouble with attention than peers of the same age who were less exposed or not exposed to acetaminophen in the womb.

Woodbury, who herself is pregnant, says she does not want to scare others away from using acetaminophen in pregnancy when needed. Extreme headaches or other painful episodes and fevers can be debilitating and even dangerous, calling for use of the drug. She said she has turned to acetaminophen once per trimester so far. But she also chooses not to use it for minor aches, pains or slight fevers.

More research is needed to test whether more frequent use of acetaminophen during the second trimester of pregnancy may be particularly problematic for the developing brain, the researchers said.

The study also is limited as participants were mostly white, non-Hispanic and of higher economic status. Schantz and her team are working to broaden the cohort of participants in IKIDS to include pregnant people from a greater diversity of social, economic and racial backgrounds.

Funding: This research was supported by the Children’s Environmental Health and Disease Prevention Research Center funded by the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency and the National Institutes of Health Environmental Influences on Child Health Outcomes program.

About this neuropharmacology and neurodevelopment research news

Author: Diana Yates
Source: University of Illinois
Contact: Diana Yates – University of Illinois
Image” The image is credited to Neuroscience News

Original Research: Open access.
The relationship of prenatal acetaminophen exposure and attention-related behavior in early childhood” by Susan Schantz et al. Neurotoxicology and Teratology


The relationship of prenatal acetaminophen exposure and attention-related behavior in early childhood

Acetaminophen is currently the only analgesic considered safe for use throughout pregnancy, but recent studies indicate that prenatal exposure to acetaminophen may be related to poorer neurodevelopmental outcomes. Multiple studies have suggested that it may be associated with attention problems, but few have examined this association by trimester of exposure.

The Illinois Kids Development Study is a prospective birth cohort located in east-central Illinois. Exposure data were collected between December 2013 and March 2020, and 535 newborns were enrolled during that period. Mothers reported the number of times they took acetaminophen at six time points across pregnancy.

When children were 2, 3, and 4 years of age, caregivers completed the Child Behavior Checklist for ages 1.5–5 years (CBCL). Associations of acetaminophen use during pregnancy with scores on the Attention Problems and ADHD Problems syndrome scales, the Internalizing and Externalizing Behavior composite scales, and the Total Problems score were evaluated.

Higher acetaminophen exposure during the second trimester of fetal development was associated with higher Attention Problems, ADHD Problems, Externalizing Behavior, and Total Problems scores at ages 2 and 3. Higher second trimester exposure was only associated with higher Externalizing Behavior and Total Problems scores at 4 years.

Higher cumulative exposure across pregnancy was associated with higher Attention Problems and ADHD Problems scores at ages 2 and 3. Findings suggest that prenatal acetaminophen exposure, especially during the second trimester, may be related to problems with attention in early childhood.

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