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Frequent use of paracetamol in late pregnancy may double risk of wheezing in young children
October 25, 2002Frequent use of the painkiller paracetamol (acetaminophen) after 20 weeks of pregnancy may increase the risk of the babies wheezing as young children, finds a study in Thorax.
The findings are based on interviews with over 9,000 pregnant mothers who were taking part in the Avon Longitudinal Study of Parents and Children (ALSPAC).
The researchers quizzed the women on their use of paracetamol and aspirin when they were 18 to 20 weeks pregnant and again at 32 weeks of pregnancy. Six months and then every year after giving birth, the mothers were asked about symptoms of wheeze and eczema in their children.
Paracetamol was taken most days or daily by just 1 per cent of the women. But in late pregnancy (20 to 32 weeks) this pattern of use was associated with a doubling in the risk of wheeze in the children when they were 3˝ after discounting other potentially influential factors. The association was stronger still among those children whose symptoms appeared before they were 6 months old.
There was no evidence that less frequent use, or heavy use of paracetamol before 20 weeks of pregnancy, increased the risk of wheeze in the children born to these mothers. Nor was there any evidence to suggest that frequent use of paracetamol during pregnancy was linked to subsequent eczema in the children.
Heavy use of aspirin was associated with a higher risk of wheeze, but only in children under 6 months old.
The authors point out that, in high doses, one of the break-down products of paracetamol can damage organs such as the liver and kidney by binding to cell proteins. Animal research has suggested that very high levels of the drug can also damage airway linings, although whether this could occur in a baby's developing lung in the womb is unknown.
But the authors are at pains to point out that only a tiny fraction of the mothers studied used paracetamol daily or on most days during late pregnancy. They recommend that if painkillers are needed, expectant mothers should still take paracetamol, rather than aspirin, but they should not use it every day.
British Medical Journal (BMJ)
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