Use of paracetamol, ibuprofen or aspirin in pregnancy and risk of cerebral palsy in the child
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Use of paracetamol, ibuprofen or aspirin in pregnancy and risk of cerebral palsy in the child. / Petersen, Tanja Gram; Liew, Zeyan; Nybo Andersen, Anne-Marie; Andersen, Guro L.; Andersen, Per Kragh; Martinussen, Torben; Olsen, Jørn; Rebordosa, Cristina; Tollånes, Mette Christophersen; Uldall, Peter; Wilcox, Allen J.; Strandberg-Larsen, Katrine.
In: International Journal of Epidemiology, Vol. 47, No. 1, 2018, p. 121–130.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Use of paracetamol, ibuprofen or aspirin in pregnancy and risk of cerebral palsy in the child
AU - Petersen, Tanja Gram
AU - Liew, Zeyan
AU - Nybo Andersen, Anne-Marie
AU - Andersen, Guro L.
AU - Andersen, Per Kragh
AU - Martinussen, Torben
AU - Olsen, Jørn
AU - Rebordosa, Cristina
AU - Tollånes, Mette Christophersen
AU - Uldall, Peter
AU - Wilcox, Allen J.
AU - Strandberg-Larsen, Katrine
PY - 2018
Y1 - 2018
N2 - Background: It has been debated whether mild analgesics, mainly paracetamol, adversely affect aspects of neurodevelopment. We examined whether mother's use of paracetamol, aspirin or ibuprofen in pregnancy is associated with increased risk of cerebral palsy (CP) in the child.Method: We included 185 617 mother-child pairs from the Danish National Birth Cohort and the Norwegian Mother and Child Cohort Study. We created harmonized definitions of analgesic use in pregnancy, as well as indications for analgesic use and other potential confounders. Children with CP were identified in nationwide registers. We estimated the average causal effect of analgesics on risk of CP using marginal structural models with stabilized inverse probability weights.Results: Paracetamol use was reported in 49% of all pregnancies, aspirin in 3% and ibuprofen in 4%. Prenatal exposure to paracetamol ever in pregnancy was associated with increased risk of overall CP [adjusted odds ratio (aOR) 1.3, 95% confidence interval (CI): 1.0-1.7] and unilateral spastic CP (aOR 1.5, 95% CI: 1.0-2.2). The association appeared to be driven by an increased risk of unilateral spastic CP in children exposed in second trimester (aOR 1.6, 95% CI: 1.0-2.5). Children ever prenatally exposed to aspirin in pregnancy had an elevated risk of bilateral spastic CP (aOR 2.4, 95% CI: 1.1-5.3) compared with unexposed.Conclusion: We observed an increased risk of spastic CP in children prenatally exposed to paracetamol and aspirin. Although we controlled for several important indications for analgesic use, we cannot exclude the possibility of confounding by underlying diseases.
AB - Background: It has been debated whether mild analgesics, mainly paracetamol, adversely affect aspects of neurodevelopment. We examined whether mother's use of paracetamol, aspirin or ibuprofen in pregnancy is associated with increased risk of cerebral palsy (CP) in the child.Method: We included 185 617 mother-child pairs from the Danish National Birth Cohort and the Norwegian Mother and Child Cohort Study. We created harmonized definitions of analgesic use in pregnancy, as well as indications for analgesic use and other potential confounders. Children with CP were identified in nationwide registers. We estimated the average causal effect of analgesics on risk of CP using marginal structural models with stabilized inverse probability weights.Results: Paracetamol use was reported in 49% of all pregnancies, aspirin in 3% and ibuprofen in 4%. Prenatal exposure to paracetamol ever in pregnancy was associated with increased risk of overall CP [adjusted odds ratio (aOR) 1.3, 95% confidence interval (CI): 1.0-1.7] and unilateral spastic CP (aOR 1.5, 95% CI: 1.0-2.2). The association appeared to be driven by an increased risk of unilateral spastic CP in children exposed in second trimester (aOR 1.6, 95% CI: 1.0-2.5). Children ever prenatally exposed to aspirin in pregnancy had an elevated risk of bilateral spastic CP (aOR 2.4, 95% CI: 1.1-5.3) compared with unexposed.Conclusion: We observed an increased risk of spastic CP in children prenatally exposed to paracetamol and aspirin. Although we controlled for several important indications for analgesic use, we cannot exclude the possibility of confounding by underlying diseases.
KW - Journal Article
U2 - 10.1093/ije/dyx235
DO - 10.1093/ije/dyx235
M3 - Journal article
C2 - 29149272
VL - 47
SP - 121
EP - 130
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
SN - 0300-5771
IS - 1
ER -
ID: 185944079