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Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study
Pavel Piler1, Jan Švancara1,2, Lubomír Kukla1
1Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic.
Insights
Exposure to paracetamol during pregnancy and infancy is linked to childhood asthma. This study in Czech children suggests a modest increased risk, supporting paracetamol
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Environmental Health
Background:
- Previous studies in Western populations linked prenatal and postnatal paracetamol use to childhood asthma.
- This study investigates this association in a Central European (Czech) birth cohort.
- It also examines the impact of aspirin use during pregnancy as a comparator.
Purpose of the Study:
- To explore the association between prenatal and postnatal paracetamol exposure and asthma development in Czech children.
- To investigate a potential additive effect of combined prenatal and postnatal paracetamol exposure.
- To compare asthma development in children exposed to paracetamol versus aspirin during pregnancy.
Main Methods:
- Utilized data from the prospective Czech European Longitudinal Study of Pregnancy and Childhood (ELSPAC).
- Included 3329 children born in the 1990s.
- Collected exposure data (paracetamol, aspirin) and covariates via maternal questionnaires; asthma diagnoses from pediatric health records.
Main Results:
- Asthma prevalence was 5% at 11 years.
- Combined prenatal and postnatal paracetamol exposure showed a significant association with asthma development (OR 1.98).
- Postnatal-only exposure was also significantly associated with increased asthma risk; prenatal-only exposure was not.
Conclusions:
- Findings support previous observations linking prenatal and early postnatal paracetamol exposure to asthma development.
- The observed effect magnitude is modest.
- Paracetamol is recommended as the preferred analgesic and antipyretic during pregnancy and early childhood.
Background:
Prenatal and postnatal paracetamol exposure has been previously associated with asthma development in childhood in Western populations. We explore the association between prenatal and postnatal paracetamol exposure and asthma development in a Central European sample of Czech children, suggesting possible additive effect of the both exposures. Furthermore, since aspirin had been used more widely during study data collection in Central Europe, we also compared asthma development for those exposed to paracetamol and aspirin.
Methods:
We used data from 3329 children born in the 1990s as members of the prospective Czech European Longitudinal Study of Pregnancy and Childhood. Data about prenatal and postnatal paracetamol and aspirin exposure, and potential covariates were obtained from questionnaires completed by mothers. Data about incident asthma were obtained from paediatrician health records.
Results:
60.9% of children received paracetamol only postnatally, 1.5% only prenatally and 4.9% of children were exposed both during pregnancy and infancy. Prevalence of asthma in following population was 5% at 11 years. Being exposed to paracetamol both in prenatal and postnatal period was associated with asthma development (unadjusted OR 1.98, 95% CI 1.02 to 3.87). Being exposed only in the postnatal period was also significantly associated with increased risk of asthma. No association between prenatal exposure only and outcome was found. A higher but non-significant risk of asthma was observed for those whose mothers used paracetamol during pregnancy compared with those who used aspirin.
Conclusions:
The main findings of this prospective birth cohort study add to previous observations linking prenatal and early postnatal paracetamol exposure to asthma development. However, the magnitude of effect is relatively modest, and therefore, we recommend paracetamol to remain the analgesic and antipyretic of choice throughout pregnancy and early childhood.
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