Reacción a "Reactions to study associating paracetamol use in pregnancy with attention and sleep problems in children"

Pain during pregnancy is common and can have many causes. Pain itself, and the reasons for pain, can be a potential source of harm for both the mother and the developing child. Paracetamol is one of the few relatively safe drugs for treating pain in pregnancy. We are constantly re-evaluating the safety of our drugs, and paracetamol is no exception.
 
There have been suggestions from animal experiments, using doses much higher than would be used by humans, that paracetamol given during pregnancy could impact the mental development of the growing child. This study [in humans] by Sznajder et al., suggests that sleep problems and attention problems could be associated with paracetamol use in pregnancy.
 
The study has a reasonable number of participants (2,423 mother-child pairs) and completed a prenatal stress questionnaire. The children were examined at 3 years of age for behaviour issues and children of mothers who did not take paracetamol compared to those who did.
 
A big problem in studies like these is the issue of other conditions, the mothers who took paracetamol were taking it for issues like fever, infection and allergies, all of which can potentially affect the mental development of the child (these are termed confounders). For example maternal stress was associated with the child being withdrawn, having sleep problems and attention problems. The authors attempted to control for these confounders, but the association of paracetamol with sleep problems and attention problems after this correction is marginal, and may simply be due to other factors associated with the need to use paracetamol for pain relief.
 
With this new study, judicious use of paracetamol is still warranted. As always pregnant women should discuss any concerns with their physicians.  With any medication, the rule is to give the smallest amount for the shortest period of time to achieve relief.