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Paracetamol in pregnancy and ADHD

Paracetamol (acetaminophen), one of our most frequently used drugs, may not be as harmless as we think. A disturbing observational study based on the Danish National Birth Cohort suggests a link between mothers consuming paracetamol in pregnancy and attention deficit hyperactivity disorder (ADHD) in their offspring (Liew Z, et al. JAMA Pediatr 2014;168:313–20). The Danish keep robust, linkable national databases relating to pregnancies, hospital diagnoses in children and prescribing, and this enabled them to analyse data from over 64 000 pregnancies, from 1996–2002. This was backed up with telephone interviews. Over half of all mothers used paracetamol while pregnant, and the children of those that did were slightly, but significantly, more likely at age 7 years to be showing ADHD-like behaviours (risk ratio 1.13; 95% CI 1.0–1.3), or receiving ADHD medications (RR 1.29; 95% CI 1.1–1.4). Use in more than one trimester of pregnancy seemed to increase the association. The effect was maintained after allowing for potential confounders, including evidence of maternal infection or inflammation and maternal mental health problems. An editorial urges caution: there are problems with this population based study, such as unreliable data on actual dose taken, as opposed to prescribed (Cooper M, Langley K. JAMA Pediatr …

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