Background: The maternal use of paracetamol during pregnancy has been associated with the development of preeclampsia. This study aims to clarify whether the connection is causal or whether it is due to reverse causation.
Methods: This study is a continuation of the retrospective case cohort study examining 2,508 pregnant women using a variety of drugs and the development of preeclampsia (1,252 women with preeclampsia and 1,256 controls). For the purposes of this study, more precise data was collected from several hospital databases of the women among this cohort who had reported taking paracetamol during pregnancy (indications, gestational period etc.); this was evaluated in association with the development of preeclampsia.
Results: 5.5% (100 cases and 37 controls) of all the study population (2,508) had clearly reported paracetamol use. Women with preeclampsia had used significantly more often paracetamol during pregnancy compared to controls (cases 8.0%, controls 2.9%, p < 0.001). The difference was most evident in the third trimester (after the 29th GW) and the use of paracetamol was associated with both mild and severe preeclampsia. Headache and "general pain" were the most common indications for medication among all paracetamol users.
Conclusions: The use of paracetamol in the third trimester of pregnancy was associated with preeclampsia. This observation indicates that association between paracetamol use and preeclampsia is probably due to reverse causation, i.e. women with preeclampsia experience more headaches due to preeclampsia symptoms since this association was not detected with the use of paracetamol in earlier stages of pregnancy.
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http://dx.doi.org/10.1186/s12884-020-03490-x | DOI Listing |
Rev Bras Ginecol Obstet
December 2024
Universidade Estadual de Campinas CampinasSP Brazil Universidade Estadual de Campinas, Campinas, SP, Brazil.
Objective: An in-depth evaluation of the published evidence is needed on self-medication, specifically the evidence focusing on vulnerable groups, such as pregnant women. This scoping review aims to provide an overview of the differences in self-medication prevalence and study characteristics among different groups, while identifying gaps in the literature.
Methods: A literature search was performed in PubMed and Web of Science, including articles published in the last 10 years for the pregnant women group (PWG) and the general population group (GPG).
Obstet Gynecol
December 2024
Department of Clinical Pharmacology, Odense University Hospital, and the Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Clinical Pharmacology & Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; Radboud University Medical Center, Nijmegen, the Netherlands; Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, and the Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; the Pharmacy Department, Rotunda Hospital and School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; the Department of Pediatrics, University of California San Diego, La Jolla, California; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Pharmakovigilanzzentrum, Embryonaltoxikologie, Institut für Klinische Pharmakologie und Toxikologie, Berlin, Germany; Mothersafe, University of New South Wales, Australia; UK Teratology Information Service and the Directorate of Women's Services, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom; the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington; the Israeli Teratology Information Service, Ministry of Health, and the Hebrew University Hadassah Medical School, Jerusalem, Israel; the Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and the Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.
Acetaminophen is a common over-the-counter medication that recently gained substantial media attention regarding its use by pregnant individuals. In this clinical perspective, we discuss the strengths and limitations of the published literature on the effect of maternal acetaminophen use in pregnancy on the child's risk of developing attention-deficit and hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD). Studies included were specifically selected on the basis of the quality and validity of ADHD or ASD outcome definitions.
View Article and Find Full Text PDFReprod Toxicol
November 2024
Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. Electronic address:
Overdose of acetaminophen (APAP) has been shown to adversely affect the outcome of pregnancy. The steroidogenic acute regulatory protein (StAR) plays a pivotal role in steroidogenesis, but the impact of APAP on StAR expression in adult human ovarian granulosa cells remains elusive. Here, we demonstrate that APAP overdose leads to the downregulation of StAR expression in the human granulosa cell tumor cell line, KGN, and in the primary culture of human granulosa-lutein (hGL) cells.
View Article and Find Full Text PDFJ Ayub Med Coll Abbottabad
November 2024
Department of Gynaecology and Obstetrics, Police Hospital Karachi-Pakistan.
Background: With the help of an evidence-based approach called "Enhanced Recovery After Surgery" (ERAS), patients can receive standardised perioperative care and recover more quickly. Many surgical specialities, such as orthopaedics, gynaecological onco-surgery, breast surgery, urology, and colorectal surgery, use ERAS protocols extensively. Improved postoperative recovery is beneficial in lowering hospital stays, and costs, and increasing patient satisfaction.
View Article and Find Full Text PDFPain Manag
September 2024
Department of Anesthesiology, Division of Women's Anesthesia, Duke University Medical Center Box 3094, Durham, NC 27710, USA.
Acute pain management requires balancing analgesia with adverse effects risk. The voltage-gated sodium channel NaV1.8 plays an important role in pain physiology, and its inhibition was shown to have analgesic effects.
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