73J / 187 – PARACETAMOL IN PREGNANCY IS NOT A RISK FACTOR FOR OVERALL
PRESCHOOL WHEEZING DISORDER, BUT SEEMS TO BE IT FOR MULTIPLE-TRIGGER
WHEEZE
Thengilsdottir H1, Goksör E1, Alm B1, Erdes L2, Möllborg P, Pettersson R4, Norvenius G1, Åberg N1,
Wennergren G1.
1University
of Gothenburg, Department of Pediatrics, Gothenburg, Sweden;
Outpatient Clinic, Skene, Sweden;
3Fyrbodal Health Care Region, Central Infant Welfare Unit, Uddevalla, Sweden;
4Pediatric Outpatient Clinic, Central Infant Welfare Unit, Mölndal, Sweden
2Pediatric
Background and Aim: A possible association between prenatal paracetamol exposure and asthma in
childhood is debated. The aim of this analysis was to test the association between prenatal
paracetamol exposure and overall preschool wheezing disorder, episodic viral wheeze and multipletrigger wheeze. Multiple-trigger wheeze has been associated with future “true” asthma.
Methods: Data were obtained from a prospective, longitudinal study of a cohort of children born in the
region of Western Sweden in 2003. 8176 families (50% of the birth cohort) were randomly selected.
The parents answered questionnaires at 6 and 12 months and at 4.5 years of age. The response rate
at 4.5 years was 4496, i.e. 83% of the 5398 questionnaires distributed at 4.5 years. We here studied
the association between maternal medication during pregnancy and wheezing at age 4.5 years.
Overall wheezing disorder was defined as recurrent wheeze (3 or more episodes during the last year)
and/or wheeze treated with inhaled corticosteroids during the last year. Episodic viral wheeze was
defined as wheezing only with viral infections and multiple-trigger wheeze as wheezing in-between
infections.
Results: 28.4 % of the mothers had used medicines during pregnancy. Paracetamol had been taken
by 7.2%, allergy medicines, including asthma medication, by 4.4% and other medication by 15.6%.
In the univariate analysis, we found an increased risk of overall wheezing disorder with both
allergy/asthma medication (OR 3.0; 95% CI 2.0-4.5) and paracetamol (OR 1.5; 1.03-2.2). In the
multivariate analysis, only the association with maternal allergy/asthma medication remained
statistically significant (OR 1.7; 1.002-2.9).
However, the risk of multiple-trigger wheeze was increased by paracetamol, both in the univariate and
multivariate analyses (OR 2.3; 1.3-4.2 and 2.4; 1.2-4.9, respectively).
The risk of episodic viral wheeze was not increased by paracetamol, neither in the univariate, nor in
the multivariate analysis, (OR 1.02; 0.6-1.8 and 0.8; 0.4-1.7).
Conclusion: Prenatal paracetamol exposure was not an independent risk factor for overall wheezing
disorder at preschool age. However, in the subgroup multiple-trigger wheeze an association with
prenatal paracetamol exposure was found. As could be expected, maternal allergy/asthma medication
during pregnancy was associated with wheezing disorder.