Paracetamol Medication During Pregnancy: Insights on Intake Frequencies, Dosages and Effects on Hematopoietic Stem Cell Populations in Cord Blood From a Longitudinal Prospective Pregnancy Cohort

Autor: Christian Wiessner, Christina Gehbauer, Gisa Tiegs, Heiko Becher, Kurt Hecher, Mirja Pagenkemper, Lars Bremer, J. Goletzke, Eva Tolosa, Petra C. Arck, Anke Diemert
Rok vydání: 2017
Předmět:
Adult
medicine.medical_specialty
Pregnancy Trimester
Third
Birth weight
Population
lcsh:Medicine
Pain
Gestational Age
General Biochemistry
Genetics and Molecular Biology
Childhood asthma
03 medical and health sciences
0302 clinical medicine
Pregnancy
FACS
fluorescence-activated cell sorting
medicine
Humans
Prospective Studies
HSC
hematopoietic stem cells
030212 general & internal medicine
gw
gestational week
education
Acetaminophen
lcsh:R5-920
Analgesics
education.field_of_study
Dose-Response Relationship
Drug
business.industry
Obstetrics
lcsh:R
digestive
oral
and skin physiology
PRINCE
PRENATAL DETERMINANTS OF CHILDREN'S HEALTH
Gestational age
General Medicine
Fetal Blood
Hematopoietic Stem Cells
medicine.disease
Lineage development
OTC
over the counter
Cord blood
Gestation
Female
lcsh:Medicine (General)
business
030217 neurology & neurosurgery
Research Paper
medicine.drug
Cohort study
Zdroj: EBioMedicine
EBioMedicine, Vol 26, Iss C, Pp 146-151 (2017)
ISSN: 2352-3964
DOI: 10.1016/j.ebiom.2017.10.023
Popis: Background Paracetamol is the first choice for antipyretic or analgesic treatment throughout pregnancy. Products with Paracetamol are readily available over the counter and therefore easily accessible for self-medication. Epidemiological data on Paracetamol intake pattern during pregnancy and its potential immunological effects are sparse. We aimed to analyze a possible association between Paracetamol medication and numbers of hematopoietic stem cells (HSC) in cord blood. Methods The objective was addressed in the PRINCE (PRENATAL DETERMINANTS OF CHILDREN'S HEALTH) study, a population-based prospective pregnancy cohort study initiated in 2011 at the University Medical Center in Hamburg, Germany. 518 healthy pregnant women with singleton pregnancies were recruited during the first trimester. Three examinations were scheduled at the end of the 1st (gestational week 12–14), the 2nd (gestational week 22–24) and the 3rd trimester (gestational week 34–36). For 146 of these women, cord blood flow cytometry data were available. Paracetamol intake was assessed for each trimester of pregnancy. Findings Among the 518 enrolled women, 40% took Paracetamol as main analgesic treatment during pregnancy. The intake frequency and dosage of Paracetamol varied between the women and was overall low with a tendency towards higher frequencies and higher dosages in the third trimester. Paracetamol intake, particularly during the third trimester, resulted in decreased relative numbers of HSCs in cord blood, independent of maternal age, first-trimester BMI, parity, gestational age and birth weight (− 0.286 (95% CI − 0.592, 0.021), p = 0.068). Interpretation Prenatal Paracetamol intake, especially during the third trimester, may be causally involved in decreasing HSCs in cord blood.
Graphical Abstract Image 1
Highlights • Paracetamol is the main analgesic agent used during pregnancy. • Maternal Paracetamol intake was negatively associated with hematopoietic stem cell frequencies in cord blood. • The third trimester seems to be most susceptible for Paracetamol induced reduction of the immune cell progenitors. Our study focuses on the impact of Paracetamol intake during pregnancy on the offspring's immune development. We were able to show that maternal Paracetamol intake, particularly in the third trimester of pregnancy, was negatively associated with hematopoietic stem cell frequencies in cord blood. These results provide a potential missing link for an association between prenatal Paracetamol medication and childhood disease, particularly asthma, by adding a possible immunological pathway. While we fully acknowledge the medical need of analgesics in pregnancy to prevent or treat more harmful events, our data are valuable for clinical recommendations on self-medication with the OTC drug Paracetamol.
Databáze: OpenAIRE
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