Paracetamol Medication During Pregnancy: Insights on Intake Frequencies, Dosages and Effects on Hematopoietic Stem Cell Populations in Cord Blood From a Longitudinal Prospective Pregnancy Cohort

Abstract

BackgroundParacetamol is the first choice for antipyretic or analgesic treatment throughout pregnancy. Products with Paracetamol are readily available over the counter and therefore easily accessible for self-medication. Epidemiological data on Paracetamol intake pattern during pregnancy and its potential immunological effects are sparse. We aimed to analyze a possible association between Paracetamol medication and numbers of hematopoietic stem cells (HSC) in cord blood.MethodsThe objective was addressed in the PRINCE (PRENATAL DETERMINANTS OF CHILDREN'S HEALTH) study, a population-based prospective pregnancy cohort study initiated in 2011 at the University Medical Center in Hamburg, Germany. 518 healthy pregnant women with singleton pregnancies were recruited during the first trimester. Three examinations were scheduled at the end of the 1st (gestational week 12–14), the 2nd (gestational week 22–24) and the 3rd trimester (gestational week 34–36). For 146 of these women, cord blood flow cytometry data were available. Paracetamol intake was assessed for each trimester of pregnancy.FindingsAmong the 518 enrolled women, 40% took Paracetamol as main analgesic treatment during pregnancy. The intake frequency and dosage of Paracetamol varied between the women and was overall low with a tendency towards higher frequencies and higher dosages in the third trimester. Paracetamol intake, particularly during the third trimester, resulted in decreased relative numbers of HSCs in cord blood, independent of maternal age, first-trimester BMI, parity, gestational age and birth weight (− 0.286 (95% CI − 0.592, 0.021), p = 0.068).InterpretationPrenatal Paracetamol intake, especially during the third trimester, may be causally involved in decreasing HSCs in cord blood.

Effects of Exposure to Acetaminophen and Ibuprofen on Fetal Germ Cell Development in Both Sexes in Rodent and Human Using Multiple Experimental Systems

“…Because studies in the United States ( Werler et al. 2005 ), Germany ( Bremer et al. 2017 ), France ( Philippat et al.…”

Paracetamol – An old drug with new mechanisms of action

“…172 Recent studies still undermine the safety of paracetamol administration in pregnant women and young children. 173 Given the common exposure to paracetamol during this period of life, there were fears that it might affect intense brain development in children. 174 The use of paracetamol during this time period has been associated with hyperkinetic disorders, hyperactivity (attention deficit hyperactivity disorder, ADHD), and other adverse behaviours later in life.…”

“…The use of paracetamol raises considerable controversy, as it has been shown to reach the fetal/neonatal brain after passing the placenta 171 and the blood brain barrier 172 . Recent studies still undermine the safety of paracetamol administration in pregnant women and young children 173 . Given the common exposure to paracetamol during this period of life, there were fears that it might affect intense brain development in children 174 .…”

Severe Pain in a Leiomyoma with Twin Pregnancy- An Analgesic Dilemma

“…Uterine leiomyomas are common, benign smooth muscle tumors originating from uterine myometrial cells. They are estimated to affect 40%-80% of women by age 50 and are present in up to 4% of pregnancies (1)(2)(3). However, severe localized abdominal pain can occur if a fibroid undergoes degeneration, torsion, or impaction, which usually occurs between the 14th and 20th week when growth of the uterus is most active (2).…”