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No link between acetaminophen use during pregnancy and adverse birth outcomes

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Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#41

Post by terribleperson »

ctoa wrote: post #23
redwall_hp wrote: post #19

Earlier quoted context omitted.

> Fatalities happen basically from: product stacking combination medicines people don't realize contain acetaminophen and/or multi-day accumulation exceeding max daily limit over multiple days. I find it obnoxious that NyQuil has taken over as the default brand people grab for cough syrup, for that reason. It has acetaminophen, while Robitussin or such have the other active ingredients without that risk. The typical…

I absolutely think we should ban acetaminophen in otc combo meds. There was a big drop in hospitalizations when they dropped the max allowed dose in prescription drugs like Vicodin, there's no reason these otc things like NyQuil need to exist at all.

I think it's supposed to be an anti-abuse thing for commonly abused drugs.

Maybe I'm crazy, but I don't think killing people is an improvement.

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#42

Post by dyauspitr »

tootie wrote: post #16

And yet I still see MAHA defenders even on HN.

> on how early a child is born or a child’s weight at birth

These are not particularly important. The concerns are autism and ADHD.

Also don’t equate that MAHA crap with disagreement on this topic. I’m as anti MAGA as it gets but this study doesn’t do anything to assuage people’s primary concerns about this.

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#43

Post by dyauspitr »

dofm wrote: post #22
anonymousiam wrote: post #17

This paper says there are no adverse effects to the mother, but it does not mention possible adverse effects to the child beyond "birth health" and does not address the recent controversy about a possible link to autism.

Why would it need to? There is no medical controversy. There’s only a weak and now discounted statistical association that was seized upon by two disgraceful anti-science politicians to create a political controversy.

It’s hard to ignore a link when the n is this large. A 15% greater chance of getting autism is very significant.

A 2024 study of nearly 2.5 million children initially found:

* Autism by age 10: 1.53% with prenatal exposure versus 1.33% without * ADHD: 2.87% versus 2.46%

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#44

Post by dofm »

dyauspitr wrote: post #43
dofm wrote: post #22

Earlier quoted context omitted.

Why would it need to? There is no medical controversy. There’s only a weak and now discounted statistical association that was seized upon by two disgraceful anti-science politicians to create a political controversy.

It’s hard to ignore a link when the n is this large. A 15% greater chance of getting autism is very significant. A 2024 study of nearly 2.5 million children initially found: * Autism by age 10: 1.53% with prenatal exposure versus 1.33% without * ADHD: 2.87% versus 2.46%

https://jamanetwork.com/journals/jama/fullarticle/2817406

This is the study you are referring to. I will leave it to others to judge your comment.

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#45

Post by mmooss »

ctoa wrote: post #39
mmooss wrote: post #35

Earlier quoted context omitted.

The Pubmed articles are from 20 years ago. The 2023 JAMA article has some qualified information: "In 2021, US poison centers received more than 80 000 cases involving an acetaminophen product.1 The National Electronic Injury Surveillance System estimated that 78 414 emergency department (ED) visits occurred annually in the US from January 1, 2006, through December 31, 2007, for overdoses of acetaminophen-containing p…

What those numbers really don't get into: ~80% of acetaminophen poisoning cases severe enough to end in hospital are intentional suicide attempts. Those patients also have better outcomes though: family members know what happened, they get them to a hospital, they can take N-acetylcysteine as a timely antidote. In the unintentional poisoning group, ~90% is from multi-day accumulation, they don't realize they've been…

Regarding the unintentional overdoses:

"There are two distinct clinical syndromes described in literature. One is the 'garden variety', wherein the patients ingested large amounts of acetaminophen with a suicidal intent .... The other pattern is seen in chronic alcoholics who ingest smaller amounts of acetaminophen in an attempt to relieve pain ...."

"The causes of chronic pain in the accidental overdose group were toothache, chronic backache, or headache."

https://link.springer.com/article/10.1186/cc1475

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#46

Post by ludwigschubert »

dofm wrote: post #44
dyauspitr wrote: post #43

Earlier quoted context omitted.

It’s hard to ignore a link when the n is this large. A 15% greater chance of getting autism is very significant. A 2024 study of nearly 2.5 million children initially found: * Autism by age 10: 1.53% with prenatal exposure versus 1.33% without * ADHD: 2.87% versus 2.46%

https://jamanetwork.com/journals/jama/fullarticle/2817406 This is the study you are referring to. I will leave it to others to judge your comment.

> Acetaminophen use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analysis. This suggests that associations observed in other models may have been attributable to familial confounding.

To spell it out: the study’s point (sorry, “Conclusions and Relevance”) is to explain away the very data GP cites?

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#47

Post by ctoa »

mmooss wrote: post #45
ctoa wrote: post #39

Earlier quoted context omitted.

What those numbers really don't get into: ~80% of acetaminophen poisoning cases severe enough to end in hospital are intentional suicide attempts. Those patients also have better outcomes though: family members know what happened, they get them to a hospital, they can take N-acetylcysteine as a timely antidote. In the unintentional poisoning group, ~90% is from multi-day accumulation, they don't realize they've been…

Regarding the unintentional overdoses: "There are two distinct clinical syndromes described in literature. One is the 'garden variety', wherein the patients ingested large amounts of acetaminophen with a suicidal intent .... The other pattern is seen in chronic alcoholics who ingest smaller amounts of acetaminophen in an attempt to relieve pain ...." "The causes of chronic pain in the accidental overdose group were t…

Yes, and those alcoholics also exactly fit the multi-day accumulation pattern. These aren't people taking one day of Tylenol after a bender for a hangover. The pattern is people with an impaired ability to process acetaminophen (alcoholics) taking multiple days of doses they can't handle (their daily safe dose is about 1/2 of normal) for chronic pain (like chronic back pain).

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#48

Post by qsera »

estearum wrote: post #25
eth0up wrote: post #24

Earlier quoted context omitted.

Because we couldn't possibly modify "we have no substantive or high-quality evidence that the drug is unsafe." - (damn all the research showing it is) --to "we have no substantive or high-quality evidence that the drug is safe." - (damn all the research suggesting it isn't) Well, that's as good a green light for an ad campaign as one could ask for. "we don't actually know that it does this." ain't never stopped a mot…

Drugs are approved for the specific uses based on extremely high-quality evidence. That evidence balances the benefits against the detectable downsides/costs/side-effects. Those downsides are also on the label . That's almost entirely generated by the highest quality evidence generation system we could possibly have, which is RCTs. And no, pharma reps actually aren't allowed to encourage (or even talk about) off-labe…

>highest quality evidence generation system we could possibly have, which is RCTs.

The "best we have" does not mean it is good enough for the task at hand. Just saying.

Basically what I am saying is that qualifying something by saying "best we have", does not justify its using on its own..

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#49

Post by qsera »

dofm wrote: post #22
anonymousiam wrote: post #17

This paper says there are no adverse effects to the mother, but it does not mention possible adverse effects to the child beyond "birth health" and does not address the recent controversy about a possible link to autism.

Why would it need to? There is no medical controversy. There’s only a weak and now discounted statistical association that was seized upon by two disgraceful anti-science politicians to create a political controversy.

>Why would it need to?

Because that is what everyone (I mean, not if you are pharma) is interested in...

Re: No link between acetaminophen use during pregnancy and adverse birth outcomes

#50

Post by qsera »

ourmandave wrote: post #26
dofm wrote: post #22

Earlier quoted context omitted.

Why would it need to? There is no medical controversy. There’s only a weak and now discounted statistical association that was seized upon by two disgraceful anti-science politicians to create a political controversy.

I can't figure it out. What is the actual reason they knowingly LIED about it? Some personal grievance against Tylenol brand? More graft from a competitor? Appease their conspiracy loving dumbass base? Destroy the scientific reputation of the US? Trump is actually that fucking stupid? All of the above?

I am not sure, but the claim was that there is some date based correlation when this drug started being used, and rise of some health issues kids...
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