Association. And correlation. Having said that in pregnancy it is always better to avoid the use of drugs if they are not absolutely necessary and are taken on medical indication, it is precisely on the difference between the two words that need to reflect when it comes to possible relationships between therapies and risks of pathologies in children.
When we talk about association, in any case, we refer to a possible relationship between two or more events or facts. It is a more labile concept, which does not require a clear cause-effect relationship. This is instead present in case of correlation. In this circumstance, however, two quantitative variables move together. If one varies, the other also changes.
Clarifying these points is important if you want to better understand what the US president Donald Trump proposed, which has reported how also the drugs, and in particular paracetamol or acetaminophen, could probably be associated with a risk “significantly increased by autism”.
What does the Food and Drug Administration (FDA) report
Trump, in addition to not recommending the intake of paracetamol to pregnant women, has indicated the next definition of a position on the issue and information to doctors for the possible risk by the Food and Drug Administration (FDA). As reported by the document of the American body, the green traffic light has been announced for a process to change the illustrative leaflet of the drugs containing acetaminophen to make you reflect on the fact that the use during the sweet expected could be associated with a greater risk of neurological conditions such as autism and ADHD. In short, we go to a principle of precaution. But substantially what emerges is the tendency to avoid the use of drugs in pregnancy without real need, including paracetamol, also because in the event of light fever there would be no one to think about treatment. But it is also reported that it is “reasonable that pregnant women use acetaminophen in certain situations”.
In short, the press release of the FDA makes clarity.
“Although numerous studies have described an association between acetaminophen and neurological conditions, a causal relationship has not been established and the scientific literature also reports contrary results. It should also be remembered that acetaminophen is the only desktop drug approved for the treatment of fever in pregnancy, while the high unrelated fever can represent a risk for the fetus”.
In short, in the logic of a precautionary principle, the morality of the American regulatory body is to suggest the use of paracetamol in pregnancy only in case of need and for a short time possible.
What we know and what can be done
Returning to the concept of association (there are no studies that show correlation and above all in the research, confontal factors can intervene that could contribute to explaining an increase in risk and are independent of the drug), it should be remembered that there are research that invite caution as the one published as meta -analysis on 46 different studies on Environmental Health. But at the same time a Swedish research has affected millions of children and in particular it focused on the brothers, noting that the intake of paracetamol in a pregnancy and not in the other did not lead to specific problems of neurological development.
In short: considering also that collecting the data with certainty is not simple (the possible use of the drug is reported by the mother and it is also necessary to consider in what phase of pregnancy the medicine has been taken and as far as), finding a definitive response is not easy. However, there is a fact that emerges in these conflicting data. There is always talk of association and not of the cause-effect relationship. On the other hand, the experts arrives a recommendation: significant pain and paintings in pregnancy must however be faced and managed by the doctor, to avoid (those who are clear) risks for the fetus related to these conditions.
In short: we are still looking for final tests. But this does not mean that it does not need to be cautious. The drugs must be used when they are needed and for the necessary time, without exaggerating. And in pregnancy, always rely on the doctor to find out what to do, especially in the first months of gestation.
Sinpia: “declarations without real scientific foundation”
The Italian company of neuropsychiatry of childhood and adolescence, Sinpia shows deep concern for the statements of the President of the United States, Donald Trump, yesterday at the press conference, regarding the use of paracetamol in pregnancy and vaccines and a possible increase in the risk of autism. And again: Trump always said that the hepatitis B vaccine, currently administered to infants, should be postponed to the age of 12. While the use of folinic acid is recommended, usually used in oncological patients during chemotherapy, for the treatment of autistic children.
“These declarations, widely taken from the media, are without real scientific foundation, create disinformation and contribute to feeding insecurities and confusion on what is a significant problem for millions of children, teenagers and families involved in neurosviluppo disorders all over the world”
Elisa Fazzi, Sinpia president, underlines.
“Autism is a complex and multifactorial neurosviluppo disorder due to the interface between genetic and environmental factors, recognized and studied for decades by the international scientific community. Research has highlighted the neurobiological and genetic bases of the autistic spectrum and the intertwining with environmental elements, but a single causal factor has not been identified. External causes such as vaccines or drugs or other factors commonly invoked in unfounded narratives “
President Sinpia continues.
“Disseminating statements not supported by scientific data and not expressing itself in tune with the community and scientific data available is not only irresponsible, but risks seriously damaging the daily efforts of doctors, therapists, educators and families, who work with commitment to encourage the research, development, inclusion and well -being of people with autism”
adds Antonella Costantino, Past President Sinpia.
