Scientific Letter
Consumption of paracetamol during pregnancy
Consumo de paracetamol durante la gestación
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"197" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "B. Castillo Barrio, M.C. Bravo Laguna, M. de la Calle Fernández, A. Pellicer Martínez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "B." "apellidos" => "Castillo Barrio" "email" => array:1 [ 0 => "bea.castillo.barrio@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M.C." "apellidos" => "Bravo Laguna" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "de la Calle Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Pellicer Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Neonatología, Hospital La Paz, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Obstetricia, Hospital La Paz, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Consumo de paracetamol durante la gestación" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 887 "Ancho" => 1526 "Tamanyo" => 75668 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Reasons for paracetamol use in pregnant women.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Recent epidemiological studies report paracetamol use in 65% of pregnant women.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Although it is known that paracetamol can cross the human placenta, there is no evidence of it producing foetal complications in animal models, and it is considered a safe drug during pregnancy.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> For this reason, paracetamol is the first-line analgesic drug used in pregnant women. However, some authors have reported finding an association between paracetamol use in pregnant women and the development of attention-deficit hyperactivity disorder and autism spectrum disorder,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> asthma,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> criptorquidism<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and foetal ductus arteriosus closure.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In reference to neonatal complications, there have been reports of newborns with heart failure and pulmonary hypertension with a known history of intrauterine exposure to paracetamol and ductus arteriosus closure. Allegaert et al. reviewed a case series in October 2018 and concluded that a causal relationship is highly probable,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> as paracetamol has been proven to be effective for therapeutic closure of patent ductus arteriosus in preterm infants.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The aim of our study was to describe the use of paracetamol by pregnant women in our area and assess their knowledge of the potential side effects of the drug on the foetus. A secondary objective was to analyse which health care professional provided this information.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We designed a prospective study with collection of data through a questionnaire administered to women admitted to the maternity ward of our hospital over a period of 3 months.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We received 900 completed questionnaires (93% of mothers in the maternity ward during the period under study). A majority of respondents had a university degree (55.5%). Of the total, 67.4% reported having used paracetamol during pregnancy, a proportion that was slightly larger compared to the previous literature. Most respondents (99%) consumed the therapeutic dose (< 4 g/day) and nearly half (45.7%) used it for a very short time interval (< 3 days). The most common reasons of paracetamol consumption are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>. The maximum daily dose of 4 or more grams per day was prescribed for management of headache (50% of cases), cold symptoms (33.3%) or toothache (16.7%). The distribution of paracetamol was similar in every trimester of pregnancy; 12.5% of respondents used it over 2 trimesters and 21.5% throughout the pregnancy.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The prescription was made most frequently by the primary care doctor (39%) or the gynaecologist (37%) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). When it came to knowledge about the drug, 26% of pregnant women believed that paracetamol had no effects on the foetus. In addition, 51.9% of pregnant women had received information from a health care professional about the effects of paracetamol. Of the group that had received information, 74% reported being told that consumption of paracetamol carried no risks to the foetus. Our study reflects the current situation in the use of paracetamol by pregnant women and in the education given by health care providers in a metropolitan area with a population characterised by a medium-to-high educational attainment.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">When it comes to the limitations of this study, given the high educational attainment of the survey respondents, most of who had a university degree, our findings may not be generalised to the general population. On the other hand, given the high response rate, our sample is representative of the population under study. Another limitation is that the items explore retrospective information, so there is a risk of recall bias. The questionnaire did not investigate how long participants consumed the maximum dose of paracetamol. Analysing neonatal outcomes was not an objective of our study. However, it would be relevant to carry out another study with an appropriate design to assess the safety of prescribing paracetamol during pregnancy, as the current evidence on the subject is scarce.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In conclusion, use of paracetamol in pregnant women in our area was greater than reported in the literature, and the information that they received on the potential adverse effects or the dosage that is considered safe was inadequate. Until the quality of the evidence improves, public health education strategies should be implemented to guarantee delivery of sufficient information and to facilitate the search for alternatives encouraging rational use of this drug in order to control consumption during pregnancy.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-10-18" "fechaAceptado" => "2019-12-16" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Castillo Barrio B, Bravo Laguna MC, de la Calle Fernández M, Pellicer Martinez A. Consumo de paracetamol durante la gestación. An Pediatr (Barc). 2020;93:196–197.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Previous presentations: This study was presented at the XXVII Congress of Neonatology and Perinatal Medicine and the VII Congress of Neonatal Nursing; October, 2019, Madrid, Spain.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 887 "Ancho" => 1526 "Tamanyo" => 75668 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Reasons for paracetamol use in pregnant women.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 810 "Ancho" => 1500 "Tamanyo" => 67002 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prescriber of paracetamol.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acetaminophen use in pregnancy: Examining prevalence, timing and indication of use in a prospective birth cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. 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| 2024 June | 4333 | 40 | 4373 |
| 2024 May | 2837 | 50 | 2887 |
| 2024 April | 2262 | 45 | 2307 |
| 2024 March | 1854 | 31 | 1885 |
| 2024 February | 2248 | 38 | 2286 |
| 2024 January | 3419 | 29 | 3448 |
| 2023 December | 2956 | 58 | 3014 |
| 2023 November | 4116 | 72 | 4188 |
| 2023 October | 4086 | 46 | 4132 |
| 2023 September | 4200 | 55 | 4255 |
| 2023 August | 5107 | 39 | 5146 |
| 2023 July | 4351 | 42 | 4393 |
| 2023 June | 4716 | 41 | 4757 |
| 2023 May | 6859 | 43 | 6902 |
| 2023 April | 5108 | 46 | 5154 |
| 2023 March | 6553 | 43 | 6596 |
| 2023 February | 4233 | 29 | 4262 |
| 2023 January | 3149 | 42 | 3191 |
| 2022 December | 2501 | 44 | 2545 |
| 2022 November | 6511 | 44 | 6555 |
| 2022 October | 7839 | 63 | 7902 |
| 2022 September | 9844 | 47 | 9891 |
| 2022 August | 8687 | 62 | 8749 |
| 2022 July | 6480 | 58 | 6538 |
| 2022 June | 2995 | 48 | 3043 |
| 2022 May | 2736 | 50 | 2786 |
| 2022 April | 2526 | 57 | 2583 |
| 2022 March | 2721 | 52 | 2773 |
| 2022 February | 3204 | 36 | 3240 |
| 2022 January | 8921 | 68 | 8989 |
| 2021 December | 4070 | 54 | 4124 |
| 2021 November | 3545 | 56 | 3601 |
| 2021 October | 5243 | 128 | 5371 |
| 2021 September | 5836 | 83 | 5919 |
| 2021 August | 4932 | 56 | 4988 |
| 2021 July | 4583 | 45 | 4628 |
| 2021 June | 3764 | 62 | 3826 |
| 2021 May | 3899 | 53 | 3952 |
| 2021 April | 8261 | 246 | 8507 |
| 2021 March | 3427 | 61 | 3488 |
| 2021 February | 1927 | 54 | 1981 |
| 2021 January | 1149 | 37 | 1186 |
| 2020 December | 424 | 19 | 443 |
| 2020 November | 139 | 17 | 156 |
| 2020 October | 73 | 22 | 95 |
| 2020 September | 227 | 34 | 261 |
| 2020 August | 6 | 3 | 9 |
Show all
