ADHD 2 X more likely if Tylenol used a lot during pregnancy (Autism increased too) – Dec 2016

Acetaminophen use in pregnancy and neurodevelopment: attention function and autism spectrum symptoms.

Int J Epidemiol. 2016 Dec 1;45(6):1987-1996. doi: 10.1093/ije/dyw115.
Avella-Garcia CB1,2,3,4,5, Julvez J1,3,6, Fortuny J7, Rebordosa C7, García-Esteban R1,3,6, Galán IR8, Tardón A6,9, Rodríguez-Bernal CL10, Iñiguez C10, Andiarena A11,12, Santa-Marina L6,12,13, Sunyer J1,3,4,5.

 Download the PDF obtained from Researchgate from VitaminDWiki

 Download the PDF commentary obtained from Researchgate from VitaminDWiki

BACKGROUND:
Acetaminophen is extensively used during pregnancy. But there is a lack of population-representative cohort studies evaluating its effects on a range of neuropsychological and behavioural endpoints. We aimed to assess whether prenatal exposure to acetaminophen is adversely associated with neurodevelopmental outcomes at 1 and 5 years of age.

METHODS:
This Spanish birth cohort study included 2644 mother-child pairs recruited during pregnancy. The proportion of liveborn participants evaluated at 1 and 5 years was 88.8% and 79.9%, respectively. Use of acetaminophen was evaluated prospectively in two structured interviews. Ever/never use and frequency of use (never, sporadic, persistent) were measured. Main neurodevelopment outcomes were assessed using Childhood Autism Spectrum Test (CAST), Conner's Kiddie Continuous Performance Test (K-CPT) and ADHD-DSM-IV form list. Regression models were adjusted for social determinants and co-morbidities.

RESULTS:
Over 40% of mothers reported using acetaminophen. Ever-exposed offspring had higher risks of presenting more hyperactivity/impulsivity symptoms [incidence rate ratio (IRR) = 1.41, 95% confidence interval (CI) 1.01-1.98), K-CPT commission errors (IRR = 1.10, 1.03-1.17), and lower detectability scores (coefficient β = -0.75, -0.13--0.02). CAST scores were increased in ever-exposed males (β = 0.63, 0.09-1.18).
Increased effect sizes of risks by frequency of use were observed for hyperactivity/impulsivity symptoms (IRR = 2.01, 0.95-4.24) in all children, K-CPT commission errors (IRR = 1.32, 1.05-1.66) and detectability (β = -0.18, -0.36-0.00) in females, and CAST scores in males (β = 1.91, 0.44-3.38).

CONCLUSIONS:
Prenatal acetaminophen exposure was associated with a greater number of autism spectrum symptoms in males and showed adverse effects on attention-related outcomes for both genders. These associations seem to be dependent on the frequency of exposure.

PMID: 27353198 DOI: 10.1093/ije/dyw115
Study - with details on Autism, is behind a publisher paywall

Comment is also behind publisher paywall

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From the web

• Does an A.D.H.D. Link Mean Tylenol Is Unsafe in Pregnancy? NYT Dec 2017
  Reporting on a study in Norway with 100,000 pregnancies - similar results: 2X increase in ADHD if take for more than 30 days
  Prenatal Exposure to Acetaminophen and Risk of ADHD - Oct 2017
   Download the Oct 2017 PDF from VitaminDWiki

From the Web Feb 2012

• Prenatal Exposure to Acetaminophen Linked to Childhood Wheezing Medscape Dec 2010
• Does Tylenol Worsen Asthma For Kids? NPR Feb 2012
• Tylenol Linked to High Rates of Asthma in Children Wellness Resources Aug 2010
  One dose of Tylenol in the past 12 months was associated with a 43% increased risk of developing asthma.
  Higher use was associated with a whopping 240% increased risk.
• Want your child to have asthma? Give them Tylenol.
  Is making your child comfortable for a day or two’s worth of low grade fever worth the risk of a lifetime issue with asthma, rhinitis or eczema?
• Study casts more doubt on acetaminophen-asthma link Reuters Dec 2010
• Tylenol Side Effects: Are You Sure that Tylenol is Safe? Side-Effects Site
  Many side effects • Kidney disease, • Liver disease, • Asthma, • Those who drink alcohol- even infrequently
  ”it has NOT been tested with the randomized double-blind placebo-controlled studies, known as RCT's,”
• Tylenol and Autism? from Evolutionary Psychiarty Jan 2012
• Does Tylenol Cause Athma? Oct 2010
  2.5 times greater in teenagers using acetaminophen at least monthly.
  The findings come from a study of 323,000 13- and 14-year-olds from 50 nations.
• NPR Science: Does Tylenol worsen asthma for kids Feb 2012
  "Everybody around the world who's looked for this association has been able to find it.”
  In fact, acetaminophen is an ingredient in many cough and cold products — including NyQuil, Robitussin and Theraflu.
  It might exacerbate the asthma because it decreases levels of a molecule called glutathione, which protects the lungs.
• Tylenol (Acetaminophen) Liver Damage many items Nov 2012

Over 600 medicines contain Acetaminophen

Over the Counter
Alka-Seltzer Plus, Anacin, Cepacol, Contac, Coricidin, Dayquil, Dimetapp, Dristan, Excedrin, Feverall, Formula 44, Liquiprin, Midol, Mucinex, Nyquil, Panadol, Robitussin, Saint Joseph® Aspirin-Free Singlet, Sinutab, Sudafed, Theraflu, Triaminic, TYLENOL® Brand Products, Vanquish, Vicks,

Prescription
Butalbital, Endocet, Fioricet, Hycotab, Hydrocet, Hydrocodone Bitartrate, Lortab, MIDRIN, NORCO, Oxycodone, Percocet, Phenaphen, ROXICET ™, Sedapap, Tapanol, Tramadol, TYLENOL® with Codeine, Tylox, Ultracet, Vicodin, Zydone®

Tylenol Side Effects, Are You Sure You're Safe?

• " , , , it's estimated that approximately 100,000 deaths per year occur from acetaminophen usage. (3) If this were a food or supplement, it would likely be considered quite dangerous, maybe even too dangerous to be sold without a prescription!"
• "And Tylenol use is one of the MAIN CAUSES of non alcoholic liver failure in the US! In fact, among all drugs sold in the US, it is the Number 2 drug that most often causes liver problems (4)."

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Is it safe to take Tylenol during pregnancy?
Acetaminophen is the main ingredient in Tylenol and many other pain medicines. It's often one of the only pain relievers doctors recommend to pregnant women for pain or fever. It's long been viewed as safe during pregnancy and is used by a large number of pregnant women in the U.S. and abroad.Aug 17, 2016
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Over-the-counter medications:
Taking acetaminophen (used for pain relief) during the first trimester of pregnancy did not appear to increase the risk of major birth defects. Also, taking acetaminophen might decrease the risk of some birth defects in the baby when a pregnant woman uses it to treat a fever.May 5, 2016
Is it safe to use acetaminophen during pregnancy? BabyCenter

• "In fact, because fevers during pregnancy can cause many risks to the developing baby, doctors recommend that you take acetaminophen if your fever is 101 degrees Fahrenheit or higher."
• "It's fine to take either regular or extra strength acetaminophen, but be careful not to take more than the amount recommended on the label. If you take too much, it can cause liver failure both in you and, later in pregnancy, in your baby."

One of the first Tylenol lawsuits $8.8 million

Lawsuits and class-action lawsuits continue thru 2017

• No apparent change by the FDA other than to reduce the maximum strength pill and put a black box warning on Tylenol, but apparently not on the 600 other medicines containing acetaminophen
    ~ Note: It is extremely easy for a person to take more than one pill