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Prenatal paracetamol exposure and risk of wheeze at preschool age

Emma Goksör1, Hrefna Thengilsdottir, Bernt Alm

  • 1Department of Paediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden. emma.goksor@vgregion.se

Acta Paediatrica (Oslo, Norway : 1992)
|July 20, 2011
PubMed

Insights

Prenatal exposure to paracetamol was linked to an increased risk of preschool wheeze, particularly multiple-trigger wheeze. This association persisted even after adjusting for other factors, suggesting a potential link between prenatal paracetamol and childhood respiratory issues.

Area of Science:

  • Pediatric Allergy and Immunology
  • Epidemiology
  • Environmental Health

Background:

  • Prenatal medication use is common, with paracetamol being widely used for pain and fever relief.
  • The potential long-term effects of prenatal drug exposure on child respiratory health remain an area of active investigation.
  • Previous studies have suggested possible associations, but further research is needed to clarify the relationship between prenatal paracetamol and childhood wheeze.

Purpose of the Study:

  • To investigate the association between prenatal exposure to paracetamol and the development of wheeze in preschool-aged children.
  • To differentiate the risk associated with different types of wheeze, specifically episodic viral wheeze and multiple-trigger wheeze.

Main Methods:

  • A prospective, longitudinal cohort study involving 8176 families in western Sweden, initiated in 2003.
  • Parental questionnaires were administered at 6 and 12 months, and at 4.5 years of age, with a response rate of 55% at the final follow-up.
  • Inhaled corticosteroid (ICS)-treated wheeze was used as a proxy for doctor-diagnosed asthma, and wheeze phenotypes were categorized as episodic viral or multiple-trigger.

Main Results:

  • Multivariate analysis revealed a significant increase in the risk of ICS-treated wheeze associated with prenatal paracetamol exposure (OR 1.6; 95% CI 1.01-2.6).
  • The association was particularly pronounced for multiple-trigger wheeze (OR 2.4; 1.2-4.8) within the ICS-treated group.
  • No significant association was found between prenatal paracetamol and episodic viral wheeze (OR 1.1; 0.5-2.3).

Conclusions:

  • Prenatal paracetamol exposure is identified as an independent risk factor for ICS-treated wheeze in preschool children.
  • The risk appears to be heightened in children with ICS-treated multiple-trigger wheeze.
  • While adjusted for key confounders like maternal asthma and antibiotic use, residual confounding by maternal indication for paracetamol use (e.g., respiratory illness) cannot be entirely excluded.
Abstract

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