Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study

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Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study

Piler, P; Svancara, J; Kukla, L; Pikhart, H; (2018) Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study. Journal of Epidemiology and Community Health , 72 (4) pp. 349-355. 10.1136/jech-2017-209960. Green open access

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Abstract

Background: Prenatal and postnatal paracetamol exposure has been previously associated with asthma development in childhood in Western populations. We explore the association between prenatal and postnatal paracetamol exposure and asthma development in a Central European sample of Czech children, suggesting possible additive effect of the both exposures. Furthermore, since aspirin had been used more widely during study data collection in Central Europe, we also compared asthma development for those exposed to paracetamol and aspirin. Methods: We used data from 3329 children born in the 1990s as members of the prospective Czech European Longitudinal Study of Pregnancy and Childhood. Data about prenatal and postnatal paracetamol and aspirin exposure, and potential covariates were obtained from questionnaires completed by mothers. Data about incident asthma were obtained from paediatrician health records. Results: 60.9% of children received paracetamol only postnatally, 1.5% only prenatally and 4.9% of children were exposed both during pregnancy and infancy. Prevalence of asthma in following population was 5% at 11 years. Being exposed to paracetamol both in prenatal and postnatal period was associated with asthma development (unadjusted OR 1.98, 95% CI 1.02 to 3.87). Being exposed only in the postnatal period was also significantly associated with increased risk of asthma. No association between prenatal exposure only and outcome was found. A higher but non-significant risk of asthma was observed for those whose mothers used paracetamol during pregnancy compared with those who used aspirin. Conclusions: The main findings of this prospective birth cohort study add to previous observations linking prenatal and early postnatal paracetamol exposure to asthma development. However, the magnitude of effect is relatively modest, and therefore, we recommend paracetamol to remain the analgesic and antipyretic of choice throughout pregnancy and early childhood.

Type:	Article
Title:	Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study
Open access status:	An open access version is available from UCL Discovery
DOI:	10.1136/jech-2017-209960
Publisher version:	http://doi.org/10.1136/jech-2017-209960
Language:	English
Additional information:	This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords:	asthma, paracetamol, birth cohort, epidemiology, ELSPAC
UCL classification:	UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI:	https://discovery.ucl.ac.uk/id/eprint/10048091