Pain Now – Or Problems Later?

New research shows link between acetaminophen use in pregnancy and ADHD in children

AUSTIN, Texas – For years, expecting moms have turned to a common pain reliever to treat the aches and pains of pregnancy.

Acetaminophen is one of the few over-the-counter drugs considered safe to use during pregnancy.

But new research published in JAMA Pediatrics this week shows women who take the medication while pregnant may increase their child’s chances of having behavioral disorders like ADHD.

Scientists at The University of Bristol looked at 7,800 mothers in the U.K. from pregnancy until the children were seven years old. More than half of mothers in the study said they’d used acetaminophen at 18 weeks.

Compared to children whose moms didn’t take acetaminophen during pregnancy:

• Mothers who took acetaminophen at 18 and 32 weeks of pregnancy reported more behavioral problems and ADHD by the time their kids turned seven.
• Kids whose mothers did take the drug had a 42% higher risk of behavioral issues and 31% higher risk for hyperactivity.
• Children whose mothers used acetaminophen while pregnant also had a higher risk of emotional problems.

More evidence pointing to an ADHD link

Sonia Krishna, MD, child and adolescent psychiatrist with the Seton Mind Institute, part of Ascension, says there have been several studies on the topic and the new research provides more evidence.

“My initial reaction was this is bad news for moms,” she said. “There are limited pain treatment options in pregnancy and now a standard medication that was deemed safe may not be. We definitely want to work with a pregnant woman to make sure that the symptoms she experiences are well controlled while making sure that the developing child has the least amount of exposures in utero.”

While Krishna says the study was well done overall, she believes the research lacked information about frequency of use.

“We really need to consider how much medication the mothers were taking, how often and for how long, to get the best picture of how it’s affecting neural development,” she said. “The reality is the majority of pregnant women used acetaminophen, but not all those children acquired ADHD.”

According to the Centers for Disease Control and Prevention, more than 5 million children in the U.S. between the ages of 4 and 17 have ADHD. The CDC estimates another 6.4 million have never been diagnosed.

The bigger picture on medication during pregnancy

In addition to the dangers of using acetaminophen, Krishna said there are very clear consequences to other pain relievers like ibuprofen.

“It’s been shown to lower amniotic fluid levels, increase blood pressure in the fetal lungs, delay or prolong labor, and can affect fetal heart development.” she said.

An increasing number of studies supports a link between women taking medications in their second and third trimesters – when babies’ brains continue to develop — and their children having psychiatric symptoms later on in life, Krishna says.

How to manage your prenatal pain without drugs

Pregnant women who do not wish to take pain relievers can choose from other methods to tackle pain such as:

• Hot and cold compresses
• Prenatal yoga
• Massage
• Meditation
• Other stress-reduction techniques

“If you have a high fever or you have really bad pain, that’s a good reason to talk to your OBGYN to rule out any underlying medical issues,” Krishna said. “You want to rule out any underlying medical issues.”

About Seton Healthcare Family

Ascension’s Texas ministry is comprised of Seton Healthcare Family and Providence Healthcare Network The Daughters of Charity founded Seton in 1902 in Austin and Providence in 1905 in Waco as a sign of God’s unconditional love for all, and today strive to expand access to high-quality, low-cost, person-centered care and services.

Seton operates more than 100 clinical locations, including four teaching hospitals that will be training sites for Dell Medical School at The University of Texas starting in 2016. Seton conducts research in such areas as the prevention and treatment of stroke, traumatic injury, epilepsy and chronic condition management. Providence operates a major hospital; a psychiatric and substance abuse resource center; and a premiere community for independent and assisted living, long-term and sub-acute care.

Both systems have strong cardiovascular and neuroscience programs. Seton, which operates Dell Children’s Medical Center of Central Texas, also is the regional leader in pediatric care. Together, in 2014, Seton and Providence provided more than $500 million in charitable care. For more information, visit http://www.seton.net/ and http://www.providence.net/.