Acetaminophen and pregnancy: short- and long-term consequences for mother and child
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Acetaminophen and pregnancy: short- and long-term consequences for mother and child. / Thiele, Kristin; Kessler, Timo; Arck, Petra; Erhardt, Annette; Tiegs, Gisa.
In: J REPROD IMMUNOL, Vol. 97, No. 1, 01.03.2013, p. 128-39.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Acetaminophen and pregnancy: short- and long-term consequences for mother and child
AU - Thiele, Kristin
AU - Kessler, Timo
AU - Arck, Petra
AU - Erhardt, Annette
AU - Tiegs, Gisa
N1 - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
PY - 2013/3/1
Y1 - 2013/3/1
N2 - Counter-intuitively, over-the-counter medication is commonly taken by pregnant women. In this context, acetaminophen (APAP, e.g. Paracetamol, Tylenol) is generally recommended by physicians to treat fever and pain during pregnancy. Thus, APAP ranks at the top of the list of medications taken prenatally. Insights on an increased risk for pregnancy complications such as miscarriage, stillbirth, preterm birth or fetal malformations upon APAP exposure are rather ambiguous. However, emerging evidence arising from human trials clearly reveals a significant correlation between APAP use during pregnancy and an increased risk for the development of asthma in children later in life. Pathways through which APAP increases this risk are still elusive. APAP can be liver toxic and since APAP appears to freely cross the placenta, therapeutic and certainly toxic doses could not only affect maternal, but also fetal hepatocytes. It is noteworthy that during fetal development, the liver transiently functions as the main hematopoietic organ. We here review the effect of APAP on metabolic and immunological parameters in pregnant women and on fetal development and immune ontogeny in order to delineate novel, putative and to date underrated pathways through which APAP use during pregnancy can impair maternal, fetal and long term children's health. We conclude that future studies are urgently needed to reconsider the safety and dosage of APAP during pregnancy and - based on the advances made in the field of reproduction as well as APAP metabolism - we propose pathways, which should be addressed in future research and clinical endeavors.
AB - Counter-intuitively, over-the-counter medication is commonly taken by pregnant women. In this context, acetaminophen (APAP, e.g. Paracetamol, Tylenol) is generally recommended by physicians to treat fever and pain during pregnancy. Thus, APAP ranks at the top of the list of medications taken prenatally. Insights on an increased risk for pregnancy complications such as miscarriage, stillbirth, preterm birth or fetal malformations upon APAP exposure are rather ambiguous. However, emerging evidence arising from human trials clearly reveals a significant correlation between APAP use during pregnancy and an increased risk for the development of asthma in children later in life. Pathways through which APAP increases this risk are still elusive. APAP can be liver toxic and since APAP appears to freely cross the placenta, therapeutic and certainly toxic doses could not only affect maternal, but also fetal hepatocytes. It is noteworthy that during fetal development, the liver transiently functions as the main hematopoietic organ. We here review the effect of APAP on metabolic and immunological parameters in pregnant women and on fetal development and immune ontogeny in order to delineate novel, putative and to date underrated pathways through which APAP use during pregnancy can impair maternal, fetal and long term children's health. We conclude that future studies are urgently needed to reconsider the safety and dosage of APAP during pregnancy and - based on the advances made in the field of reproduction as well as APAP metabolism - we propose pathways, which should be addressed in future research and clinical endeavors.
KW - Acetaminophen
KW - Antipyretics
KW - Child
KW - Female
KW - Fetal Development
KW - Fetus
KW - Humans
KW - Liver
KW - Maternal Exposure
KW - Mothers
KW - Pregnancy
KW - Pregnancy Complications
KW - Prenatal Exposure Delayed Effects
U2 - 10.1016/j.jri.2012.10.014
DO - 10.1016/j.jri.2012.10.014
M3 - SCORING: Journal article
C2 - 23432879
VL - 97
SP - 128
EP - 139
JO - J REPROD IMMUNOL
JF - J REPROD IMMUNOL
SN - 0165-0378
IS - 1
ER -