Paracetamol and Asthma: is the evidence is robust enough to change the
guidelines: an overview of systematic reviews
Abstract
Objective: To conduct an umbrella review collating the existing evidence
to determine whether there is an association between exposure of
paracetamol in utero or in infancy, and the development of childhood
asthma. Methods: In this review, systematic reviews with or without
meta-analysis that reported the association between paracetamol and
asthma in children were included. To identify relevant reviews, a search
was performed in the electronic databases PubMed, the Cochrane Central
Register of Controlled Trials Library, and Ovid. Results: The search
strategy in various databases identified 1913 conceivably significant
studies for inclusion. After removal of 493 duplicates ,1420 studies
were screened for titles and abstracts against a standard eligibility
criterion. Full text screening yielded four systematic reviews to be
included in this review. Prenatal paracetamol exposure is associated
with an increased risk of Asthma in the offspring. Of the four
systematic reviews, 2 have an unclear risk of bias, one has a high risk
and one has a low risk of bias. Association does not imply causation and
we recommend further research to answer this very important question. In
the absence of any other alternative, paracetamol will have to continue
to be the safest and the most widely prescribed analgesic and
antipyretic in pregnancy. Conclusions: We recommend further research to
answer this very important question. In the absence of any other
alternative, paracetamol will have to continue to be the safest and the
most widely prescribed analgesic and antipyretic in pregnancy.