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PSA test levels lower in obese patients

Nerys Hairon sifts through the latest research on the safety of commonly used drugs in pregnant women

Women who take paracetamol in late pregnancy may be at increased risk of having a

child who goes on to develop asthma, a Government-funded study suggests.

Researchers estimate as many as 7 per cent of childhood asthma cases could be attributable to paracetamol exposure, although they caution that no causal link has yet been established.

Mothers who took paracetamol most days or daily after 20 weeks of pregnancy were at 62 per cent increased risk of having an asthmatic child. Those who took it sometimes had a 22 per cent raised risk.

There was also evidence the children of mothers who had taken paracetamol had raised levels of immunoglobulin E. Mean IgE was 52 per cent higher where mothers had taken the drug most days or daily and 14 per cent higher where sometimes taken. There was no association between paracetamol and hay fever, eczema or skin test positivity.

Study author Dr Seif Shaheen, senior lecturer in epidemiology at Guy's, King's and St Thomas' School of Medicine, said the results should be interpreted with caution: 'I would continue to recommend paracetamol as the preferred analgesic for pregnant women. While we still cannot be sure this is a causal link, I would advise they shouldn't take paracetamol excessively or unnecessarily, especially in late pregnancy, and should not exceed the recommended dosage.'

Dr David Bellamy, member of the British Thoracic Society and a GP in Bournemouth, said: 'I think the main message is caution. If you can avoid using paracetamol in pregnant women do. But some may need to take painkillers and it's a matter of balancing the relative risk over benefits.'

Dr Martyn Walling, a GP with a special interest in women's health in Boston, Lincolnshire, said he would need more evidence before he stopped prescribing or recommending paracetamol.

Dr Shaheen, an Asthma UK senior research fellow, said he planned to investigate genes and paracetamol toxicity.

The study was published in Clinical and Experimental Allergy (January).

Common drugs which should

be avoided in pregnancy

·NSAIDs All NSAIDs should be avoided except for aspirin 75mg for recurrent miscarriages

·Antibiotics Tetracyclines should not be used during pregnancy and metronidazole avoided in the first trimester

·Antihistamines Majority are contraindicated

in pregnancy

·ACE inhibitors for hypertension Pregnant women should be changed to another antihypertensive

·Anti-epileptic drugs Dosage and number of epilepsy drugs should be reduced in consultation with a neurologist

·Oral hypoglycaemic drugs for type 2 diabetes Patients should be changed to insulin

Source: consultant obstetricians

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