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对乙酰氨基酚对心理健康的胎儿编程作用?对母胎医学协会声明的回应:孕期使用对乙酰氨基酚与注意缺陷多动障碍

Fetal programming of mental health by acetaminophen? Response to the SMFM statement: prenatal acetaminophen use and ADHD.

作者信息

Olsen Jørn, Liew Zeyan

机构信息

a Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.

b Department of Epidemiology , Fielding School of Public Health, University of California, Los Angeles (UCLA) , Los Angeles , CA , USA.

出版信息

Expert Opin Drug Saf. 2017 Dec;16(12):1395-1398. doi: 10.1080/14740338.2017.1384812. Epub 2017 Oct 3.

Abstract

A number of studies indicate that acetaminophen taken during pregnancy may have a programming effect on the fetal brain development. The potential adverse consequences may only surface to clinical detection years later. Should we act on these findings now or do we wait for additional evidence? Areas covered: We argue for action inspired by these well analyzed studies that are based on five prospective cohorts data collected from different countries. Several analytical options have been employed especially to address confounding, and all analyses have consistently suggested that confounding alone is an unlikely explanation for this disturbing observation. Expert opinion: Acetaminophen is often used for minor symptom or discomfort where the treatment has no strong indication and carries little, if any risk for the pregnant women. The harm of doing nothing may well exceed the harm for taking precautionary actions considering the consequences at stake.

摘要

多项研究表明,孕期服用对乙酰氨基酚可能会对胎儿大脑发育产生编程效应。潜在的不良后果可能要在数年之后才会显现出来以供临床检测。我们现在应该依据这些发现采取行动,还是等待更多证据呢?涵盖领域:我们主张基于对来自不同国家的五个前瞻性队列数据进行充分分析的研究结果采取行动。尤其采用了多种分析方法来解决混杂因素问题,并且所有分析均一致表明,仅混杂因素不太可能解释这一令人不安的观察结果。专家意见:对乙酰氨基酚常用于轻微症状或不适,此时治疗并无强烈指征,而且对孕妇即便有风险也微乎其微。考虑到所涉后果,无所作为的危害很可能超过采取预防措施的危害。

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