Intravenous paracetamol for neonates: long-term diseases not escalated during 5 years of follow-up. Issue 2 (17th September 2020)

• Record Type: Journal Article
• Authors: Juujärvi, Sanna; Saarela, Timo; Pokka, Tytti; Hallman, Mikko; Aikio, Outi
• Is Part Of: Archives of disease in childhood. Volume 106:Issue 2(2021)
• Page Start: 178
• Page End: 183
• Publication Date: 2020-09-17
• Subjects: allergy -- autism -- neurodevelopment -- pain -- intensive care; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2020-319069
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Objective: To evaluate the long-term adverse reactions of paracetamol in children who required intensive care shortly after birth. Paracetamol is a widely used analgesic in neonates, but the long-term studies are lacking. Previous epidemiological studies have reported associations between early paracetamol intake and diseases in childhood. Design: Five-year follow-up cohort of children who required intensive care shortly after birth. Setting: Single tertiary care hospital; neonatal and paediatric intensive care units. Interventions: Intravenous paracetamol was administered for pain and discomfort to the neonates during their intensive care, while for the control infants, it was not available. Main outcome measures: The primary outcome was the incidence of asthma; secondary outcomes were neonatal diseases and long-term morbidities (atopic dermatitis, inflammatory bowel disease, autism, speech disorders, cerebral palsy). Long-term morbidities were adjusted based on antenatal and neonatal risk factors. Results: We screened all neonates admitted to the intensive care units soon after birth in Oulu University Hospital, Oulu, Finland, during 1 October 2007 to 31 December 2013. Altogether, 1552 infants needed intensive care. Of them, 735 (47%) were treated with intravenous paracetamol. We obtained their long-term data from the Finnish National Institute for Health and Welfare, including all physician-made diagnoses from all primary healthcare units and hospitals in Finland. We found no difference in the asthma incidence or in other long-term morbidities between paracetamol-treated and non-exposed infants. Conclusions: Intravenous paracetamol given to neonates did not associate with childhood disorders compared with the non-exposed infants during the 5-year follow-up. The previous hypothesis that early paracetamol use causes childhood morbidities was not confirmed. Abstract : Paracetamol exposure in neonatal life (pain, discomfort) is not associated with childhood disorders (asthma, atopic dermatitis, inflammatory bowel disease, autism, speech disorders, cerebral palsy) when compared to non-exposed cases at the age of 5 years in one NICU.