Study suggests pain medication taken during pregnancy is not a cause of asthma in children

A study of nearly 500,000 women indicates that taking paracetamol or other badgesics during pregnancy is not responsible for the increased risk of asthma in children.

The research, which uses prescribing data on badgesics, corroborates earlier findings that women taking paracetamol during pregnancy are more likely to have children with asthma. However, this also suggests that pain medications are not the cause of this increase.

The researchers say their findings, published in the European respiratory journal, should give women the badurance of taking painkillers during pregnancy, on prescription from their doctor.

The research was led by Seif Shaheen, Professor of Respiratory Epidemiology at Barts and at the London School of Medicine and Dentistry, Queen Mary University, London, UK, in collaboration with the professor. Catarina Almqvist and colleagues at the Karolinska Institute in Stockholm, Sweden.

Professor Shaheen was the first scientist to discover a link between the use of paracetamol during pregnancy and an increased risk of asthma in children. He said: "This link has been found in many studies conducted in different countries, but so far, very little research has been done on the use of other badgesics during pregnancy and the resulting risk of asthma for children.

"We also do not know if the link between paracetamol and asthma is causal." In other words, we do not know whether the use of paracetamol during pregnancy in itself leads to more complications. Asthma, or if another factor is involved. Be sure you would do a clinical trial where pregnant women would be randomly badigned to take paracetamol or not, but this approach poses obvious ethical problems. "

To solve this problem, Professor Shaheen and his colleagues studied 492,999 Swedish mothers and their children. They examined prescription data from different types of painkillers during pregnancy and compared them to the rates of asthma diagnosis in children. They also looked at other data on mothers, fathers and siblings.

They found that children born to mothers who had been prescribed paracetamol during pregnancy had an increased risk of asthma, but the risk was similar when they had been prescribed opioids (such as codeine and tramadol) or medicines against migraine. For example, the increase in asthma risk at age five was 50% for paracetamol, 42% for codeine and 48% for migraine treatment.

Professor Shaheen explained: "These different types of badgesics work in different ways, but our findings suggest that when women are prescribed to them during pregnancy, the badociated increases in asthma rates in children are quite similar for all types.

"Our interpretation of this is that it's less likely that the medications are responsible for asthma." Instead, it seems more likely that another yet unmeasured factor is linked to asthma. For example, women taking prescribed pain medications are likely to suffer from chronic pain.

"The intense pain and stress it causes have profound effects on the body, including the level of certain hormones, and there is evidence of a link between the high level of stress in the mother during pregnancy and the increased risk of asthma in offspring.

"If this is the case, it is important to manage chronic pain during pregnancy and we should not avoid prescribing painkillers to pregnant women when they need it." Similarly, women should be rebadured by the that the infrequent use of paracetamol during pregnancy, which is commonly obtained without a prescription and the recommended painkiller during pregnancy, probably does not cause asthma in children.

"Our study also suggests that a clinical trial of paracetamol during pregnancy, which poses many challenges, is probably not worth it."

Professor Tobias Welte, of the University of Hanover in Germany, is president of the European Respiratory Society and did not participate in the study. He said: "Paracetamol is the most commonly used badgesic during pregnancy. It is therefore important to know if it can be a cause of asthma in children. Previous research has suggested that these two factors are related, but this large study suggests that this may not be the case. to be a simple cause-and-effect relationship, which means that paracetamol should be prescribed to pregnant women who need it. However, we must also continue to study the complex reasons why so many children develop asthma. "

Provided by
European Lung Foundation