Prenatal exposure to acetaminophen and respiratory symptoms in the first year of life

Persky, Victoria; Piorkowski, Julie; Hernández, Elena; Chávez, Noel; Wagner-Cassanova, Cynthia; Vergara, Carmen; Pelzel, Darlene; Enriquez, Rachel; Gutiérrez, Sílvia; Busso, Adela

doi:10.1016/s1081-1206(10)60492-9

Cited by 70 publications

(69 citation statements)

References 39 publications

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“…The use of this medicine during pregnancy is not associated with increased risk of abortion, stillbirth, low weight birth or increased prevalence of congenital anomalies Rebordosa et al, 2009). However, an association between use of acetaminophen during pregnancy and the prevalence of childhood asthma has been demonstrated (Henderson and Shaheen, 2013;Persky et al, 2008;Rebordosa et al, 2008a). Therefore, the prescription of this drug for pregnant women should be done with caution.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of medication use among low risk pregnant women: A drug utilization study

Fontoura¹,

Ayres²,

Martins-Nagai³

et al. 2014

Afr. J. Pharm. Pharmacol.

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This study aimed to characterize the profile of medication consumption by low risk pregnant women and to correlate it with sociodemographic characteristics of this population. A cross-sectional descriptive study was conducted in the Reference Center of Women's Health in the Brazilian municipality of Ribeirão Preto. This study included women which were at least in the 32nd week of the gestation period. Data related to sociodemographic characteristics of the pregnant women and to their pregnancy and medication consumption were collected from June, 2008 to November, 2008. A total of 699 pregnant women were included. About 20% of the pregnant women began prenatal care in the 12th week of gestation and 75.3% had at least six antenatal visits. The use of at least one drug during pregnancy was reported by 98% of the participants. The mean number of medications used was 4.35. According to the Food and Drug Administration (FDA) risk classification, 14.07% of the medication belonged to C category, 1.85% to D and 0.03% to X, and 38.30% were not identified or not classified by the FDA. When correlating the number of prenatal visits with the amount of medication used, it was verified that pregnant women who underwent less than six visits during pregnancy used a higher number of medications. Pregnant women have been exposed to a variety of medications and there is a need to improve the quality of care in order to prevent potential risks to the fetus, especially in relation to the use of medications.

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Section: Discussionmentioning

confidence: 99%

Prevalence of medication use among low risk pregnant women: A drug utilization study

Fontoura¹,

Ayres²,

Martins-Nagai³

et al. 2014

Afr. J. Pharm. Pharmacol.

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“…The acetaminophen and asthma hypothesis has attracted interest for more than a decade (19) and many studies, although primarily cross-sectional, have independently demonstrated an increased prevalence of asthma and other allergic conditions among acetaminophen users (8,9,(11)(12)(13)(14)(15)(16)(17)(18)(19). Our current findings fit with our previous research in children and adults in the same Butajira study area, which reported a similar level of acetaminophen use (42% vs. 39% in the current study), and a significant dose-dependent association with wheeze (15).…”

Section: Discussionmentioning

confidence: 99%

“…The evidence to date implicating acetaminophen in the etiology of asthma and other allergic diseases has been remarkably consistent (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), with adverse effects reported in relation to acetaminophen exposure in utero (8)(9)(10)(11), during infancy (11,12), in childhood (13,14), and during adult life (15)(16)(17)(18). The relation also extends to objective markers of allergy (14)(15)(16).…”

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confidence: 90%

The Role of Acetaminophen and Geohelminth Infection on the Incidence of Wheeze and Eczema

Amberbir¹,

Medhin²,

Alem³

et al. 2011

Am J Respir Crit Care Med

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Rationale: Acetaminophen has been hypothesized to increase the risk of asthma and allergic disease, and geohelminth infection to reduce the risk, but evidence from longitudinal cohort studies is lacking. Objectives: To investigate the independent effects of these exposures on the incidence of wheeze and eczema in a birth cohort. Methods: In 2005-2006 a population-based cohort of 1,065 pregnant women from Butajira, Ethiopia, was established, to whom 1,006 live singleton babies were born. At ages 1 and 3, questionnaire data were collected on wheeze, eczema, child's use of acetaminophen, and various potential confounders, along with a stool sample for geohelminth analysis. Those without wheeze (n 5 756) or eczema (n 5 780) at age 1 were analyzed to determine the independent effects of geohelminth infection and acetaminophen use in the first year of life on the incidence of wheeze and eczema by age 3. Measurements and Main Results: Wheeze and eczema incidence between the ages of 1 and 3 were reported in 7.7% (58 of 756) and 7.3% (57 of 780) of children, respectively. Acetaminophen use was significantly associated with a dose-dependent increased risk of incident wheeze (adjusted odds ratio 5 1.88 and 95% confidence interval 1.03-3.44 for one to three tablets and 7.25 and 2.02-25.95 for >4 tablets in the past month at age 1 vs. never), but not eczema. Geohelminth infection was insufficiently prevalent (,4%) to compute estimates of effect. Conclusions: These findings suggest frequent acetaminophen use early in life increases the risk of new-onset wheeze, whereas the role of geohelminth infection on allergic disease incidence remains to be seen as the cohort matures.

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“…A large Danish cohort study suggested an increase risk of preterm birth in mothers with pre-eclampsia (Rebordosa et al, 2009 Level III-3) following paracetamol exposure in early pregnancy; no increased prevalence of congenital anomalies (Rebordosa, Kogevinas, Horvath-Puho et al, 2008 Level III-3); but a slight increase in asthma in infants (Rebordosa, Kogevinas, Sorensen et al, 2008 Level III-3). A smaller study reported an increased risk of wheeze in offspring if exposure to paracetamol occurred in mid to late pregnancy (Persky et al, 2008 Level IV).…”

Section: Paracetamolmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Prenatal exposure to acetaminophen and respiratory symptoms in the first year of life

Abstract: Background-Prevalence of asthma in developed countries increased between the 1970s and the 1990s. One factor that might contribute to the trends in asthma is the increased use of acetaminophen vs aspirin in children and pregnant women.

Cited by 70 publications

References 39 publications

Prevalence of medication use among low risk pregnant women: A drug utilization study

Prevalence of medication use among low risk pregnant women: A drug utilization study

The Role of Acetaminophen and Geohelminth Infection on the Incidence of Wheeze and Eczema

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

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