Aceminophin, Tylenol in the United States and Pharacetamol in Europe, is a commonly used over the counter pain medication that is commonly used in developed countries. It is currently sued by 46-56% of pregnant women in these developed countries. This is because it is considered the safest analgesic (pain medication) for pregnant AFAB and children.
A meta analysis was published in the European Journal of Epidemiology on April 20, 2021. This meta analysis was aimed to determine if a group of 6 European population based birth/child were more likely to be autistic or have ADHD due to aceminophin use.
This meta analysis was brought about because of two other meta analysis explored the same hypothesis. The method of analysis was not reliable so they decided to conduct another meta analysis. They were unclear whether or not girls or boys are effected differently by aceminophin exposure.
Epidemiology is the branch of medicine that deals with incidence, distribution and possible control of diseases and other factors relating to health.
A meta analysis is a statistical analysis that combines results from multiple scientific studies that had be performed previously. In other words, already published studies were read through and similarity in their results were found. This is not a study in itself, it combines multiple studies to come up with a result.
Sample
A sample is a group in a study that is used to represent a subset of a population. In this study the 6 groups of mothers were the sample group used to represent pregnant mothers in Europe.
The sample group was made up of 6 European population based birth groups. The mother child pairs were recruited from 1991 through 2008.
The total sample size was 73,881 children with available data on either prenatal or postnatal exposure of acetaminophen and their child was diagnosed with autism or ADHD. 60.5% of the children were recruited at the baseline.
Informed consent was obtained from the local Institutional Review Board. This review board oversees the studies to make sure they are ethical.
Exposure
Prenatal
The mothers who participated were interviewed two, three and four times during their pregnancies using standard questionnaires. They were asked if they had taken medication from the month before getting pregnant or beginning of the pregnancy through delivery.
They did not ask whether or not the mothers were autistic or had ADHD. They also did not evaluate the mothers to see if they were autistic or had ADHD. This study does not rule out the genetic component.
Postnatal
Mothers were interviewed or completed questionnaires about medication their children have taken one, or two times in the first 18 months of life of their child. At each interview, mothers were asked if they had given any medication including acetaminophen to their child. Children were classified as postnatal exposed to acetaminophen if the had taken any dose of acetaminophen at any time up to 18 months of life. Otherwise they were considered non exposed.
This too is flawed. They did not take into account breastfeeding. Anything that is taken in has a potential to be in the breastmilk. If the children didn’t take the medication, they could have been exposed to it through breastfeeding.
Outcomes
Autism and ADHD signs were assessed using parent questionnaires or linked hospital records. According to this study they mostly used parent checklists.
The checklists that were used were:
- Development and Well Being Assessment
- Pervasive Developmental Problems Sub-scale of the Child Behavior Checklist for Toddlers
- Childhood Autism Spectrum Test
- Autism Spectrum Condition Scale
- Conner’s Parent Raiting Scale Revised Short Form
- Hyperactivity/Inattention sub scale of the Strengths and Difficulties Questionnaire
- Attention Deficit and Hyperactivity problems sub-scale
The basis of the results of this study were the questionnaires filled out by the mothers. Questionnaires can be easily manipulated and are not scientifically sound. They cannot be unbiased and give a reliable result.
Results
Across studies 14 and 56% of mothers reported that they used acetaminophen in the prenatal period. A wider range of child postnatal acetaminophen exposrure was reported from 6% to 92.8 percent across the groups previously studied.
The total number of children with autistic or ADHD traits within their “borderline” range was 1,481 and 1,393 respectively.
According to their findings, children exposed are 19% more likely to display autistic traits. The odds of developing ADHD traits within the borderline range was 21% higher.
Basic research teaches us that correlation does not equal causation. If I breathe oxygen and I am autistic, it does not mean everyone who breathes oxygen is autistic. Its basic research.
There are more resources now to diagnose ADHD and autism. This study does not even consider the comorbid conditions that are more common in the autistic community such as Ehlors Danlos Syndrome, Polycystic Ovarian Syndrome, Irlen syndrome, Fibromyalgia and many others. This pain medication is essential for functioning sometimes. This study is flawed at best and not scientific at the worst. This study has so many holes, one can drive a truck through it.
Sources:
Definitions from Oxford Languages
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