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Acetaminophen

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  • Prenatal exposure to acetaminophen accelerates the onset of puberty in females.

    Puberty refers to the period of sexual development and maturation and the achievement of fertility. The onset of puberty varies between individuals and is influenced by both genetic and environmental factors, including prenatal exposures. Findings from a 2018 study suggest that prenatal exposure to acetaminophen accelerates the onset of puberty in females.

    Acetaminophen is a widely use pain reliever and fever reducer. Although it is generally considered safe for use during pregnancy, a growing body of evidence suggests that acetaminophen is an endocrine disruptor. Endocrine disruptors mimic or interfere with normal hormonal processes in the human body and may influence health throughout the lifespan.

    The study involved nearly 16,000 children (and their mothers) enrolled in the Puberty Cohort of the Danish National Birth Cohort. The mothers provided information about their acetaminophen use during pregnancy via phone interviews conducted during and after pregnancy. Starting at the age of 11 years and continuing every six months until they reached sexual maturity, the children provided information about their achievement of specific puberty-related events, such as underarm hair growth, menarche (the first period), first ejaculation, and others.

    The investigators found that prenatal exposure to acetaminophen accelerated puberty in females by as much as three months, especially if the mother took the drug more than 12 weeks. Exposure to the drug did not appear to affect the onset of puberty in males.

    These findings suggest that acetaminophen exerts dose-dependent endocrine disruptive effects during fetal development, thereby influencing pubertal timing. Because early onset of puberty is associated with a wide range of chronic diseases, including obesity, type 2 diabetes, and some cancers, further study is needed to determine whether acetaminophen use during pregnancy is safe.

  • From the article:

    Human tissues exposed to either drug for one week in a dish had reduced numbers of cells that give rise to sperm and eggs, called germ cells, the study found.

    Ovaries exposed to paracetamol for one week had more than 40 per cent fewer egg-producing cells. After ibuprofen exposure, the number of cells was almost halved.

    Experts say this is important because girls produce all of their eggs in the womb, so if they are born with a reduced number it could lead to an early menopause.

    Painkiller exposure during development could have effects on unborn boys too, the study found. Testicular tissue exposed to painkillers in a culture dish had around a quarter fewer sperm-producing cells after exposure to paracetamol or ibuprofen.

  • Acetaminophen use during pregnancy may impair fetal neurodevelopment.

    Acetaminophen, a drug used to treat pain and reduce fever, has a generally favorable safety profile and is considered safe for use during pregnancy. However, evidence from studies in rodents and humans suggests that acetaminophen exerts endocrine-disrupting properties, which could alter neurological development. Findings from a 2014 study suggest that children of women who took acetaminophen during pregnancy are more likely to develop attention-deficit/hyperactivity disorder (ADHD)-like behavioral problems or hyperkinetic disorders.

    ADHD is a neurobehavioral condition characterized by inattention and/or hyperactive or impulsive behavior that interferes with functioning, learning, or development. The condition affects more than 9 percent of children living in the United States. Hyperkinetic disorders are conditions characterized by abnormal involuntary movements, such as tremors or tics. The disorders affect 1 to 2 percent of people worldwide and are more common among males.

    The investigators drew on data from nearly 65,000 children and mothers enrolled in the Danish National Birth Cohort study. They collected information about the mothers' acetaminophen use during pregnancy via phone interviews and identified children with ADHD or hyperkinetic disorders via parental reports, medical records, and prescription records.

    They found that more than half of the women reported taking acetaminophen during their pregnancies. Children of the women who took the drug during pregnancy were 13 percent more likely to have ADHD-like behaviors at the age of 7 years; 29 percent more likely to take ADHD medications; and 37 percent more likely to be diagnosed with a hyperkinetic disorder at birth. These findings held true even after considering possible confounders, such as maternal inflammation, infection during pregnancy, the mother’s mental health problems, or others. The investigators noted longer prenatal exposure strengthened the associations between acetaminophen use and neurodevelopmental disorders.

    These findings suggest that acetaminophen use during pregnancy influences fetal brain development, potentially increasing the risk of ADHD or hyperkinetic disorders. The investigators posited that if their findings are indicative of causal associations, acetaminophen should no longer be considered safe for use during pregnancy. However, the American College of Obstetrics and Gynecology continues to support the use of acetaminophen during pregnancy.

  • From the article:

    In the first study of its kind, researchers have found an elevated rate of language delay in girls at 30 months old born to mothers who used acetaminophen during pregnancy, but not in boys.

    […]

    Language delay was seen in 10 percent of all the children in the study, with greater delays in boys than girls overall. However, girls born to mothers with higher exposure – those who took acetaminophen more than six times in early pregnancy – were nearly six times more likely to have language delay than girls born to mothers who did not take acetaminophen. These results are consistent with studies reporting decreased IQ and increased communication problems in children born to mothers who used more acetaminophen during pregnancy.