Acetaminophen (APAP), also known as paracetamol, is commonly prescribed to reduce pain and fever during pregnancy. It is the active ingredient in several over-the-counter (OTC) and prescription medicines like Tylenol. Though short-term use of acetaminophen is not associated with many risks, a recent study has linked long-term acetaminophen use during pregnancy with a 220 percent increase in the risk for attention deficit hyperactivity disorder (ADHD) in offspring.
The study, published in the journal Pediatrics in October 2017, was undertaken by a team of Norwegian researchers who analyzed data compiled by the Norwegian Institute of Public Health (NIPH). Eivind Ystrøm, a senior researcher at the NIPH and lead author, said that expectant mothers need not abstain from short-term acetaminophen usage for fever or pain relief. However, he advised pregnant women requiring constant use of acetaminophen for a longer period (29 days or more) to consult their physicians. Using acetaminophen for less than seven days during pregnancy was found to be associated with a decreased ADHD risk in children.
Fathers who used acetaminophen in the six months preceding conception also added to the risk of ADHD in the offspring by nearly two times. Although the researchers were not able to explain this finding, it was suggested that fathers using high levels of acetaminophen were predisposed to a higher genetic risk for ADHD or that changes in sperm could result from long-term use of the medication. The researchers were also unable to establish a cause-effect relationship between acetaminophen and ADHD.
‘Doesn’t add anything to our medical knowledge’
Some experts are not convinced about the study’s findings. According to Alison G. Cahill, maternal fetal medicine specialist and a member of the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice, the study “does not add anything to our medical knowledge.” Although she praised the study for enlisting a large number of participants, she felt that it was unable to overcome certain challenges and limitations in design, primarily the method of diagnosing ADHD.
For the study, children’s ADHD diagnoses were not confirmed in a laboratory but taken from codes in their electronic medical records. In the absence of any medical test to diagnose ADHD, it can only be detected through behavior, which may cause variations in diagnoses among different doctors. Moreover, this variability, along with differences in methods of assessment, renders it possible that a child had a related disorder and not ADHD.
Although there are no precise numbers of ADHD children, the American Psychiatric Association (APA) estimates the occurrence at 5 percent. The Centers for Disease Control and Prevention (CDC) previously found that nearly 11 percent children aged between 4 and 17 years had ever been diagnosed with ADHD by 2011.
In the absence of a direct association between acetaminophen and developmental issues in children, experts warn against asking pregnant women to prematurely stop or change their usage of acetaminophen-based products. They advise patients to consult their doctors and specialists to continue treating any pregnancy-related medical conditions.
Treating ADHD in children
ADHD is a brain disorder characterized by continuous patterns of inattention and/or hyperactivity-impulsivity which impair functioning or development. The earliest symptoms can emerge between the ages of three and six years and can last into adolescence and adulthood.
ADHD can be comprehensively diagnosed only by a licensed clinician, like a pediatrician, psychologist or psychiatrist with specialization in ADHD. While there is no cure for ADHD, commonly used treatments to manage the symptoms include medication (stimulants and non-stimulants), psychotherapy, and education and training. Several tools are available for parents and teachers to help children stay organized and follow directions.
White River Academy, one of the leading ADHD boarding schools in the U.S, provides help to teen boys aged 12 to 17 years who struggle with ADHD and other behavioral disorders. It focuses on helping them develop life skills and alter problematic behavior. Contact our 24/7 helpline or chat online with our specialist for more information on one of the best boarding schools for boys with ADHD.