皮膚科 劉權毅醫師

21 October 2011

Sci Total Environ 2011: 409: 5205–5209

MedWire News: Acetaminophen use by pregnant women does not increase childhood eczema risk on its own, but is a significant risk factor when combined with exposure to fine particulate pollution in the air, suggest study results.

"A potential role of paracetamol (acetaminophen…) in the pathogenesis of eczema has been suggested by many studies linking prenatal or postnatal use of this drug to asthma and other allergic disorders," say Wieslaw Jedrychowski (Jagiellonian University Medical College, Krakow, Poland) and colleagues.

However, the degree of fetotoxicity from acetaminophen is likely to depend on the "efficiency of detoxication by glutathione conjugation, which may be reduced at fetal exposure to ambient hazards inducing oxidative stress responses," they explain.

To investigate this further, Jedrychowski and team assessed the effects of acetaminophen use during pregnancy on infantile eczema risk, both alone and in combination with significant exposure to fine particulate matter (PM2.5) in the air, as PM2.5 is a "potent inducer" of oxidative stress.

In total, 322 women living in the inner city in Krakow were recruited to take part in the study between January 2001 and February 2004. All the women gave birth to term babies and were followed-up for 5 years with their children.

Acetaminophen use in pregnancy was assessed by interview and PM2.5 exposure over 48 hours was assessed in women during their second trimester of pregnancy.

After birth, the women were interviewed about their child's health every 3 months for 2 years and every 6 months thereafter.

As reported in the journal Science of the Total Environment, the researchers found that maternal exposure to acetaminophen in pregnancy alone or exposure to high amounts of PM2.5 (above 53 µg/m3) alone did not significantly increase the risk for infantile eczema.

But, when combined, the researchers found that prenatal acetaminophen exposure plus high PM2.5 exposure increased the risk for infantile eczema a significant six-fold.

"The findings of our study suggest that paracetamol use by mothers in pregnancy is not an independent risk factor for allergy outcomes such as eczema in children, however, even very small doses of paracetamol taken in pregnancy may contribute to the occurrence of eczema in early childhood if there is prenatal co-exposure to higher airborne fine particulate matter," conclude the researchers.

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