مصرف استامینوفن در بارداری و بیش فعالی کودک

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مصرف استامینوفن در بارداری و بیش فعالی کودک

عوارض استامینوفن بر بیش فعالی کودک

مصرف استامینوفن در باردرای، ریسک ابتلا به ADHD در کودکان را بیشتر از دو برابر می کند

 

 مطالعه‌ای که به تازگی صورت گرفته و نتایج آن در نشریه‌ی Pediatrics منتشر شده، شواهد بیشتری در مورد ارتباط بین استفاده از استامینوفن در دوران بارداری و ADHD کودک در سالهای بعد ارائه داد. بنا بر یک سری از تحقیقات، اختلال بیش فعالی- کم توجهی یا همان ADHD رو به افزایش است، که البته علت دقیق آن هنوز مشخص نیست.
 
اخیرا برخی از دانشمندان روی مصرف استامینوفن در دوران بارداری به عنوان فاکتوری بالقوه مطالعاتی انجام داده‌اند. مصرف این داروی موجود روی پیشخوان داروخانه‌ها که نیازی به تجویز پزشک ندارد، در دوران بارداری نسبتا بی‌خطر بوده و توصیه می‌شود برای تب و درد از آن استفاده شود.
 
در ایالات متحده‌ی آمریکا، بیش از ۷۰ درصد از زنان باردار از استامینوفن استفاده می‌کنند و بین ۵۰ تا ۶۰ درصد از زنان باردار در شمال و غرب اروپا استامینوفن مصرف می‌کنند. در سالهای اخیر، نسبت به ارتباط بین مصرف داروهای موجود روی پیشخوان داروخانه‌ها و ابتلا به ADHD، اطمینان خاطر داده شده است.
 
تحقیقات در مورد استامینوفن و ADHD
مطالعه‌ای که در سال ۲۰۱۳ در نروژ صورت گرفت دریافت بچه‌هایی که مادران‌شان در دوران بارداری به مدت ۲۸ روز و یا بیشتر، استامینوفن مصرف کرده بودند، در سن سه سالگی دچار اختلال‌های حرکتی و ادراکی شده بودند. همچنین مطالعه‌ای در سال ۲۰۱۴ در دانمارک انجام شد که ارتباط بین مصرف استامنیوفن در دوران بارداری و بروز علائم ADHD کودک در سن هفت سالگی را نشان داد. سپس تحقیقات بیشتری روی این مطالعات انجام شد و مقالات زیادی در این مورد منشتر شد. یکی از این تحقیق‌ها، ارتباط بین مصرف استامینوفن در دوران بارداری و رفتارهای ADHD مانند کودک در سنین ۷ تا ۱۱ سالگی را اثبات کرد.

نکته‌ای که این میان وجود دارد این است که مثلا، استامینوفن برای زنان بارداری که مشکلاتی چون بیماری‌های التهابی یا خود ایمنی دارند تجویز می‌شود. این بیماری‌ها نیز به خودی خود، منجر به اختلالات عصبی – رشدی در کودک می‌شوند. بنابراین ممکن است این بیماری‌ها، دلیل ابتلای کودک به ADHD باشند، نه مصرف استامینوفن.

مشکل دیگر هم این است که مصرف استامینوفن در زنان باردار با ابتلای مادر به وسواس‌های مادرانه ارتباط داده شد؛ یعنی ژن‌هایی این میان فعال هستند که موجب رفتارهای وسواس آمیز در مادر شده و روی ابتلای کودک به ADHD اثر می‌گذارند. در تازه‌ترین مطالعه‌ی انجام شده، دانشمندان سعی کردند برخی از این متغیرهای گیج کننده را رمزگشایی کنند. مثلا علائم ADHD کودکان را در مادران مبتلا به افسردگی تحت کنترل گرفتند، زیرا افسردگی، ریسک فاکتوری برای ADHD است.

همچنین آنها نقش مصرف استامینوفن توسط پدر را نیز بررسی کردند. در مطالعات قبلی این فرضیه وجود داشت که استامینوفن می‌تواند فعالیت غدد درون ریز در بیضه‌ها را مختل کند و بر رشد مغز فرزندان آینده‌ی مردها اثر بگذارد.

در تحقیقی که در نروژ انجام شد، ۱۱۴۷۴۴ کودک که بین سالهای ۱۹۹۹ و ۲۰۰۹ متولد شده بودند و ۹۵۲۴۲ مادر و ۷۵۲۱۷ پدر مورد بررسی قرار گرفتند. در بین این مادران، تقریبا نیمی از آنها در دوران بارداری از استامینوفن استفاده کرده بودند. این تیم تحقیقاتی دریافت که مصرف استامینوفن به مدت ۷ روز یا کمتر در دوران بارداری، ارتباطی با ADHD نداشت، اما مصرف طولانی مدت‌تر، یعنی بیشتر از ۷ روز، ریسک ابتلا به ADHD را افزایش داده بود.

 عوارض استامینوفن بر بیش فعالی کودکاستامینوفن می‌تواند در  هورمون‌های جنسی که در رشد مغز جنین دخالت دارند، اختلال ایجاد کند

 
بچه‌های مادرانی که به مدت ۲۹ روز استامینوفن مصرف کرده بودند، ریسک ابتلا به ADHD در آنها بیشتر از دو برابر شده بود. همچنین بچه‌های مادرانی که برای کاهش تب و درمان عفونت به مدت ۲۲ تا ۲۸ روز، استامینوفن مصرف کرده بودند، شش برابر بیشتر در معرض ADHD قرار داشتند!

دانشمندان با بررسی اطلاعات مربوط به پدران دریافتند آنهایی که به مدت ۲۹ روز یا بیشتر قبل از بسته شدن نطفه، استامینوفن مصرف کرده بودند، فرزندان‌شان دو برابر بیشتر در معرض ADHD بودند.

به گفته‌ی این دانشمندان:
«ارتباط بین مصرف استامینوفن توسط پدران قبل از بسته شدن نطفه و ADHD، مشابه ارتباط بین مصرف استامینوفن توسط مادران در دوران بارداری و ADHD بوده است.»

این مطالعه، شهودی بوده و به همین دلیل نمی‌تواند علت و معلول را مشخص کرد. اما در این مطالعه سعی شد با دقت فراوان، تا جایی که امکان داشت متغیرهای گمراه کننده حذف شوند.

علت این ارتباط چه می‌تواند باشد؟
تئوری‌هایی وجود دارد که علت و چگونگی تاثیر استامینوفن بر احتمال ADHD در جنین متولد نشده را توضیح می‌دهد. سرپرست‌های این مطالعات، سه تئوری را اینگونه ارائه می‌دهند:

۱. در مدل موش، مصرف استامینوفن توسط مادر، موجب افزایش فاکتور نورون زایی مشتق شده از مغز شده و منجر به تغییر رفتار شده بود.

۲. استامینوفن می‌تواند در هورمون‌های مادر مانند تیروئید و هورمون‌های جنسی که در رشد مغز جنین دخالت دارند، اختلال ایجاد کند.

۳. استامینوفن می‌تواند به طور بالقوه، بواسطه‌ی استرس اکسیداتیو، رشد مغز را مختل کند و منجر به مرگ نرون‌ها شود.

اما تا کنون هنوز دقیقا مشخص نیست که کدام یک از این تئوری‌ها و مکانیسم‌ها درست یا مهم هستند و به تحقیقات گسترده‌تری نیاز است. اما به این دلیل که مصرف استامینوفن رواج بسیار زیادی دارد و ADHD نیز در حال حاضر مورد توجه عموم است، تحقیقات و مطالعات بیشتر حتما به زودی انجام خواهند شد.

 

منبع: bartarinha.ir

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