New study: Tylenol in pregnancy may cause ADHD

[MrsDarcy]

There's a thought now that acetaminophen (Tylenol) taken during pregnancy may be linked to an increased risk of ADHD. I'm not saying one way or another, but this has been in the news today, so you may want to read this study (or others) and make a decision for yourself.

www.cbsnews.com/news/acetaminophen-tylenol-during-pregnancy-adhd-children/

[rbp]

Great. So pain = misery.

ETA: "Women who took acetaminophen for 20 or more weeks during pregnancy almost doubled the risk the child would have HKD, and increased the chance a child would take ADHD medications by more than 50 percent, compared to moms who did not take the drug."

That's A LOT of acetaminophen.

[MrsDarcy]

Haha, yeah I know.

[kermit]

I can't find anything that mentions how much had to be taken to see an effect. I've taken it maybe 4 times during this whole pregnancy and I can't imagine that is enough to be a problem.

I see the thing about 20 weeks but that could technically mean every day multiple times a day for 20 weeks, or a handful of times spread out across 20 weeks. There's a huge difference. I'm probably overthinking it and I'm not really worried anyway. Although when I heard it on the news my first thought was that SO's mom must have taken a lot of Tylenol while she was pregnant with him lol.

[MrsDarcy]

Feb 25, 2014 13:58:45 GMT -5 kermit said:

I can't find anything that mentions how much had to be taken to see an effect. I've taken it maybe 4 times during this whole pregnancy and I can't imagine that is enough to be a problem.

I see the thing about 20 weeks but that could technically mean every day multiple times a day for 20 weeks, or a handful of times spread out across 20 weeks. There's a huge difference. I'm probably overthinking it and I'm not really worried anyway. Although when I heard it on the news my first thought was that SO's mom must have taken a lot of Tylenol while she was pregnant with him lol.

Hahaha, that's exactly what my H said, "my mom must have taken a shitton of Tylenol when she was pregnant with me."

Yeah, there's a lot of unknowns here. I just wanted to mention it in case people were interested. I'm not a big medicine taker pregnant or not, but I also haven't had a lot of pain. Just something good to watch out for.

[IndiaInk]

I read a bit about this last night and the study does not seem at all conclusive (as the authors freely admit). Until further research is done, I don't think it is something to worry about, other than avoiding taking too much acetominophen. Acetominophen certainly is in everything these days and that is a concern because it is easy to overdose on it and it's definitely not as innocuous as we have been led to believe.

I'm not a big medicine-taker either. I have been taking a Tylenol every few weeks for the severe headaches I've been getting during this pregnancy. I dislike having to do that, but I highly doubt it is going to cause any problems. Anyway, the authors of the study do not recommend that anyone change their practices or medical advice based on this study, so I am not even going to give it another thought.

[ringstrue]

"The study was observational, meaning it does not imply a cause-and-effect relationship between taking acetaminophen during pregnancy and these problems."

So in other words - they have nothing.

[FastHands]

It says that the group that reported taking it during pg (presumably at all) had an increased rate, but it doesn't say HOW increased. I'd like to read the full study.

[rbp]

Feb 25, 2014 13:58:45 GMT -5 kermit said:

I can't find anything that mentions how much had to be taken to see an effect. I've taken it maybe 4 times during this whole pregnancy and I can't imagine that is enough to be a problem.

I see the thing about 20 weeks but that could technically mean every day multiple times a day for 20 weeks, or a handful of times spread out across 20 weeks. There's a huge difference. I'm probably overthinking it and I'm not really worried anyway. Although when I heard it on the news my first thought was that SO's mom must have taken a lot of Tylenol while she was pregnant with him lol.

The way that the news media spins science stories is sometimes out of control. I'm going to see if I can make any sense of the original paper, though I'm not a physician so this may be a losing battle.

[rbp]

Feb 25, 2014 14:15:25 GMT -5 ringstrue said:

"The study was observational, meaning it does not imply a cause-and-effect relationship between taking acetaminophen during pregnancy and these problems."

So in other words - they have nothing.

Also, the ADHD symptoms were self-reported by the parents. LOL

[MrsDarcy]

Feb 25, 2014 14:23:21 GMT -5 rbp said:

Feb 25, 2014 14:15:25 GMT -5 ringstrue said:

"The study was observational, meaning it does not imply a cause-and-effect relationship between taking acetaminophen during pregnancy and these problems."

So in other words - they have nothing.

Also, the ADHD symptoms were self-reported by the parents. LOL

[br
Seriously?!? Oh, good lord. Disregard this whole post, then!

[Deleted]

Damed if you do, damed if you don't.

This article looks at study showing untreated fevers in pg may increase autism risk of child.

mobile.nytimes.com/blogs/well/2012/06/04/fever-in-pregnancy-tied-to-autism-risk/

As a two time autism parent, I'll be hanging on to my Tylenol.

[FastHands]

Feb 25, 2014 14:15:25 GMT -5 ringstrue said:

"The study was observational, meaning it does not imply a cause-and-effect relationship between taking acetaminophen during pregnancy and these problems."

So in other words - they have nothing.

No. All studies of this nature are observational. It would be unethical (and unfundable) to say "we think that this causes a problem for kids. So we're going to have you all take it and then compare to a group that didn't." A bigger study would help lend weight, but even that is still observational and will never really be able to PROVE a cause, because you can't control all of the other variables. Human studies an non-lethal conditions are hugely challenging and flawed, but they still have the potential to trach us SOMETHING about correlation if not causation.

[rbp]

OMG 13.5% of women in the study smoked >9 cigarettes/day??  :?

[rbp]

From the research paper: "Prenatal exposure to acetaminophen also increased the risk for receiving an HKD diagnosis or ADHD medications (Table 4). Point estimates for use in either the first, second, or third trimesters were similar and confidence intervals overlapped largely. However, we estimated consistently higher risks for use in 2 or 3 trimesters and a significant trend with increasing number of weeks of use (P trend <.001). When women reported having used acetaminophen for 20 or more weeks during pregnancy, the risk for HKD diagnosis in children almost doubled (hazard ratio, 1.84; 95% CI, 1.39-2.45) and the risk for receiving ADHD medication increased by 50% (hazard ratio, 1.53; 95% CI, 1.21-1.94). Results were similar when restricting to mothers who did not report psychiatric illnesses or episodes of fever, inflammation, and infections during pregnancy (eTable 2 in Supplement)."

[ringstrue]

Feb 25, 2014 14:25:53 GMT -5 FastHands said:

Feb 25, 2014 14:15:25 GMT -5 ringstrue said:

"The study was observational, meaning it does not imply a cause-and-effect relationship between taking acetaminophen during pregnancy and these problems."

So in other words - they have nothing.

No. All studies of this nature are observational. It would be unethical (and unfundable) to say "we think that this causes a problem for kids. So we're going to have you all take it and then compare to a group that didn't." A bigger study would help lend weight, but even that is still observational and will never really be able to PROVE a cause, because you can't control all of the other variables. Human studies an non-lethal conditions are hugely challenging and flawed, but they still have the potential to trach us SOMETHING about correlation if not causation.

But its not news. Not yet, anyway. 

[rbp]

Feb 25, 2014 13:58:45 GMT -5 kermit said:

I can't find anything that mentions how much had to be taken to see an effect. I've taken it maybe 4 times during this whole pregnancy and I can't imagine that is enough to be a problem.

I see the thing about 20 weeks but that could technically mean every day multiple times a day for 20 weeks, or a handful of times spread out across 20 weeks. There's a huge difference. I'm probably overthinking it and I'm not really worried anyway. Although when I heard it on the news my first thought was that SO's mom must have taken a lot of Tylenol while she was pregnant with him lol.

From the research paper: "We were unable to assess the influence of dosage or number of pills taken because mothers were unable to recall this information accurately, and about 28% of mothers who reported acetaminophen use were unable to specify the gestational week of use; thus, we assigned trimester of exposures according to the time of interview."

[FastHands]

Feb 25, 2014 14:30:38 GMT -5 ringstrue said:

Feb 25, 2014 14:25:53 GMT -5 FastHands said:

No. All studies of this nature are observational. It would be unethical (and unfundable) to say "we think that this causes a problem for kids. So we're going to have you all take it and then compare to a group that didn't." A bigger study would help lend weight, but even that is still observational and will never really be able to PROVE a cause, because you can't control all of the other variables. Human studies an non-lethal conditions are hugely challenging and flawed, but they still have the potential to trach us SOMETHING about correlation if not causation.

But its not news. Not yet, anyway. 

Eh, as long as its limits are honestly stated, I think it's worth hearing about. Especially given some of the other drivel that counts as news.

[jewel]

I didn't actually read the article, but there should be consideration for WHY these women are taking Tylenol for 20+ weeks, and the impact that that may have on fetal development (the medication could easily just be the middle man). Do they have some sort of ongoing health issues? Is this group more likely to take other medications, smoke, etc.?

My baby may be doomed. I have had completely unmanageable headaches for the past couple weeks, and have been taking Tylenol daily. And I'll continue to take it because that's what I have to do to survive right now. Oh well.

[FastHands]

Feb 25, 2014 14:26:13 GMT -5 rbp said:

OMG 13.5% of women in the study smoked >9 cigarettes/day??  :?

Wow!! Get with it, Denmark!

[aqualuv]

I saw this on GMA this morning. H told me about it last night.

My entire philosophy while pregnant has been to only take meds IF I really need them. During the first trimester I had nagging headaches but only took Tylenol on two occasions I think.

[rbp]

Feb 25, 2014 14:49:52 GMT -5 jewel said:

I didn't actually read the article, but there should be consideration for WHY these women are taking Tylenol for 20+ weeks, and the impact that that may have on fetal development (the medication could easily just be the middle man). Do they have some sort of ongoing health issues? Is this group more likely to take other medications, smoke, etc.?

Those factors were controlled for in the statistical analysis.

[MrsDarcy]

Thanks for your educated take on this, rbp! (As crazy as it may be...)

eta: the study is crazy, not your take.

[rbp]

Feb 25, 2014 15:59:54 GMT -5 MrsDarcy said:

Thanks for your educated take on this, rbp! (As crazy as it may be...)

eta: the study is crazy, not your take.

I am doing my best! My conclusion is there might be something to it, but I will still take acetaminophen on occasion when I have a fever or a bad headache. 

[jewel]

Feb 25, 2014 15:57:49 GMT -5 rbp said:

Feb 25, 2014 14:49:52 GMT -5 jewel said:

I didn't actually read the article, but there should be consideration for WHY these women are taking Tylenol for 20+ weeks, and the impact that that may have on fetal development (the medication could easily just be the middle man). Do they have some sort of ongoing health issues? Is this group more likely to take other medications, smoke, etc.?

Those factors were controlled for in the statistical analysis.

LOL, I probably should have actually read the article then.

That said, I think that the general belief for most (if not all) medications recommended during pregnancy is that the benefits they offer outweigh the risks. If anyone thought that popping Tylenol and tictacs were equally (not) risky, well.....then this article definitely gives them something to think about.

I took quite a bit of Tylenol and Robitussin last week, at the advice of my doctor. Hopefully this was a better option than the fever, and coughing to the point of barfing. Who knows. And unless someone gives me another pain killer option, I'll continue to take Tylenol when I need it.

[IndiaInk]

Feb 25, 2014 14:34:36 GMT -5 rbp said:

Feb 25, 2014 13:58:45 GMT -5 kermit said:

I can't find anything that mentions how much had to be taken to see an effect. I've taken it maybe 4 times during this whole pregnancy and I can't imagine that is enough to be a problem.

I see the thing about 20 weeks but that could technically mean every day multiple times a day for 20 weeks, or a handful of times spread out across 20 weeks. There's a huge difference. I'm probably overthinking it and I'm not really worried anyway. Although when I heard it on the news my first thought was that SO's mom must have taken a lot of Tylenol while she was pregnant with him lol.

From the research paper: "We were unable to assess the influence of dosage or number of pills taken because mothers were unable to recall this information accurately, and about 28% of mothers who reported acetaminophen use were unable to specify the gestational week of use; thus, we assigned trimester of exposures according to the time of interview."

What?! In my mind, this makes the whole study a waste of time.  I feel like this is another instance of the media thinking it makes a good headline and preying on parent's fears by getting us all freaked out.  

[Deleted]

I think it is a bunch of crap. I will go ahead and give my uneducated opinion about an article I haven't read If like PP stated the parents were the ones reporting ADHD behavior, couldn't it be that a mother that overmedicates herself during pregnancy would also be likely to overmedicate her children? How many other substances/things have people guessed would increase the risk of ADHD?? (Pitocin, growth hormones, pesticides, too much screen time, lack of discipline, lack of physical exercise,radiation,etc) How do they rule out all of the other crap we expose ourselves to in order to come up with that? Also, when we don't know how many pills they take, when they took them precisely, etc...
It seems a little over the top to me. I had my dad tell me about it today to be careful about taking it, but honestly in pregnancy I take as little as possible and if I'm taking tylenol, it is because I really need it and this study won't change that.