*Updated to add that this post was quoted in part by the New York Times's Motherlode blog. Also, I highly suggest reading my toxicologist friend Susie's post which explains the data and statistics involved in the study, and why some reporting about it is inaccurate and/or overblown.
A study published yesterday in JAMA Pediatrics shows a strong correlation between acetaminophen use during pregnancy and ADHD diagnoses and behavioral problems. More than 64,000 children and mothers were studied over a six year period in Denmark, and were assessed across three major criteria: parental reports of their 7 year old children, hospital diagnoses of HKD (hyperkinetic disorders), and ADHD prescriptions.
It turns out that not only were children of mothers who had used acetaminophen during pregnancy more likely to have HKD, take ADHD medication, or have ADHD-like behaviors, but that in mothers who used it more frequently and/or during more than one trimester, the exposure response trends were even greater. The study's authors concluded "Maternal acetaminophen use during pregnancy is associated with a higher risk for HKDs and ADHD-like behaviors in children" but also say more research is needed.
One of the few pain reliever / fever reducer over-the-counter medicines long considered "safe" for pregnant women, acetaminophen has not actually been categorized by the FDA for pregnancy risk. And while there is no formal advisory for pregnant women to avoid acetaminophen as of yet, many will likely err on the side of caution and abstain until further research can provide more clarity.
But for those women like myself who have already taken acetaminophen during pregnancy and have a child or children already diagnosed with ADHD, this study may provoke self-recrimination and severe guilt: if only I had not been so selfish and powered through those headaches drug-free, my child might not have this problem today. If only I'd given up my personal comfort in the face of vague, potential threats to my unborn baby, he wouldn't be in therapy, on medication, and at a disadvantage. It's a bitter pill to swallow, then and now.
The more we carefully curate our prenatal choices, the more we open ourselves up to scrutiny: everything becomes an opportunity for blame and second-guessing. The more items we add to the knocked up no-no's list, the more we cling to the idea we can control health outcomes through sheer will. The more we try to gestate perfect babies, the less tolerance we have for those that are imperfect, or for the people who made them.
And for those who say ADHD isn't real, or is only the manifestation of poor parenting skills, or is caused by refined sugar, or gluten, or video games, or vaccinations? It's unclear which side of the debate has more fuel now. Further study is required.