Episode Chapters
- Guttate Psoriasis19:10Paper Chase #1 - HPV Vaccine Safety7:58Constipation | Part OneFree Chapter23:04Paper Chase #2 - Umbilical Hernia Repair Timing2:51Constipation | Part Two22:46Drug-Drug Interactions | Part One16:31Paper Chase #3 - Heavy Menses and Bleeding Disorders7:01Drug-Drug Interactions | Part Two16:16MOCA: Development of 3 to 5 Year Olds25:56Paper Chase #4 - Back Pain After Scoliosis Surgery5:31Ode to the Node: Pediatric Lymphadenopathy27:09Renal Tubular Acidosis (RTA)17:58Paper Chase #5 - In Utero Acetaminophen and Development Disorder Risk9:26The Mailbag16:49
The authors argue cord biomarkers of acetaminophen exposure was associated with an increased risk of both ADHD and autism spectrum disorders. There are however methodological concerns and the Benaroch would not draw any conclusions from this study.
Peds RAP April 2020 Written Summary 211 KB - PDF
Arsany B. - May 24, 2020 8:56 PM
Hello all,
This has been a very interesting segments and I appreciate your comments and thoughts. I also just came across a study from 2017 published in Pediatrics and then used AAP Grand Rounds February 2018 with more details. I would love to hear your feedback given the summation of the 2 studies.
Study: https://pediatrics.aappublications.org/content/140/5/e20163840?ijkey=5a468a97567e7c5981d860f9b26a1b66e148db88&keytype2=tf_ipsecsha
AAP Grand Rounds: https://aapgrandrounds.aappublications.org/content/39/2/17
Thank you.
Arsany Basily from Seattle, WA.
Solomon B., MD - May 26, 2020 11:06 AM
Hi Arsany- thx for writing in! Here is what our paper chaser Roy had to say about this: Roy says:
this is an observational study, so it can pick up potential associations, but cannot be used to infer causality. They've tried to adjust for confounders, but as always with these studies if you miss one more more confounders, you can reach the wrong conclusions. The authors of this study claim in their conclusion that though the short-term use of acetaminophen was negatively associated with later ADHD (meaning it was associated with a DECREASED risk), long term use was associated with an increased risk. There are some odd things, though. The risk from acetaminophen used for 3 or 4 weeks was substantially more than the risk from longer term use, which is biologically implausible. Also, the risk found based on paternal use was actually in the same ballpark as maternal use, which also makes no sense if the medication itself were modulating the effect via placental transfer.
So, bottom line, I'm not sure what to make of this. I would say at this point there isn't convincing evidence of harm from APAP during pregnancy and the risk of ADHD.
Hope this helps (and thank you to Roy!)
Arsany B. - May 26, 2020 11:48 AM
Thank you so much. I appreciate the feedback.