Prenatal and postnatal exposure to acetaminophen in relation to autism spectrum and attention-deficit and hyperactivity symptoms in childhood: Meta-analysis in six European population-based cohorts
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Prenatal and postnatal exposure to acetaminophen in relation to autism spectrum and attention-deficit and hyperactivity symptoms in childhood : Meta-analysis in six European population-based cohorts. / Alemany, Silvia; Avella-Garcia, Claudia; Liew, Zeyan; Garcia-Esteban, Raquel; Inoue, Kosuke; Cadman, Tim; Lopez-Vicente, Monica; Gonzalez, Llucia; Riano Galan, Isolina; Andiarena, Ainara; Casas, Maribel; Margetaki, Katerina; Strandberg-Larsen, Katrine; Lawlor, Deborah A.; El Marroun, Hanan; Tiemeier, Henning; Iniguez, Carmen; Tardon, Adonina; Santa-Marina, Loreto; Julvez, Jordi; Porta, Daniela; Chatzi, Leda; Sunyer, Jordi.
In: European Journal of Epidemiology, Vol. 36, 2021, p. 993–1004.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prenatal and postnatal exposure to acetaminophen in relation to autism spectrum and attention-deficit and hyperactivity symptoms in childhood
T2 - Meta-analysis in six European population-based cohorts
AU - Alemany, Silvia
AU - Avella-Garcia, Claudia
AU - Liew, Zeyan
AU - Garcia-Esteban, Raquel
AU - Inoue, Kosuke
AU - Cadman, Tim
AU - Lopez-Vicente, Monica
AU - Gonzalez, Llucia
AU - Riano Galan, Isolina
AU - Andiarena, Ainara
AU - Casas, Maribel
AU - Margetaki, Katerina
AU - Strandberg-Larsen, Katrine
AU - Lawlor, Deborah A.
AU - El Marroun, Hanan
AU - Tiemeier, Henning
AU - Iniguez, Carmen
AU - Tardon, Adonina
AU - Santa-Marina, Loreto
AU - Julvez, Jordi
AU - Porta, Daniela
AU - Chatzi, Leda
AU - Sunyer, Jordi
PY - 2021
Y1 - 2021
N2 - The potential etiological role of early acetaminophen exposure on Autism Spectrum Conditions (ASC) and Attention-Deficit/Hyperactivity Disorder (ADHD) is inconclusive. We aimed to study this association in a collaborative study of six European population-based birth/child cohorts. A total of 73,881 mother-child pairs were included in the study. Prenatal and postnatal (up to 18 months) acetaminophen exposure was assessed through maternal questionnaires or interviews. ASC and ADHD symptoms were assessed at 4-12 years of age using validated instruments. Children were classified as having borderline/clinical symptoms using recommended cutoffs for each instrument. Hospital diagnoses were also available in one cohort. Analyses were adjusted for child and maternal characteristics along with indications for acetaminophen use. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. The proportion of children having borderline/clinical symptoms ranged between 0.9 and 12.9% for ASC and between 1.2 and 12.2% for ADHD. Results indicated that children prenatally exposed to acetaminophen were 19% and 21% more likely to subsequently have borderline or clinical ASC (OR = 1.19, 95% CI 1.07-1.33) and ADHD symptoms (OR = 1.21, 95% CI 1.07-1.36) compared to non-exposed children. Boys and girls showed higher odds for ASC and ADHD symptoms after prenatal exposure, though these associations were slightly stronger among boys. Postnatal exposure to acetaminophen was not associated with ASC or ADHD symptoms. These results replicate previous work and support providing clear information to pregnant women and their partners about potential long-term risks of acetaminophen use.
AB - The potential etiological role of early acetaminophen exposure on Autism Spectrum Conditions (ASC) and Attention-Deficit/Hyperactivity Disorder (ADHD) is inconclusive. We aimed to study this association in a collaborative study of six European population-based birth/child cohorts. A total of 73,881 mother-child pairs were included in the study. Prenatal and postnatal (up to 18 months) acetaminophen exposure was assessed through maternal questionnaires or interviews. ASC and ADHD symptoms were assessed at 4-12 years of age using validated instruments. Children were classified as having borderline/clinical symptoms using recommended cutoffs for each instrument. Hospital diagnoses were also available in one cohort. Analyses were adjusted for child and maternal characteristics along with indications for acetaminophen use. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. The proportion of children having borderline/clinical symptoms ranged between 0.9 and 12.9% for ASC and between 1.2 and 12.2% for ADHD. Results indicated that children prenatally exposed to acetaminophen were 19% and 21% more likely to subsequently have borderline or clinical ASC (OR = 1.19, 95% CI 1.07-1.33) and ADHD symptoms (OR = 1.21, 95% CI 1.07-1.36) compared to non-exposed children. Boys and girls showed higher odds for ASC and ADHD symptoms after prenatal exposure, though these associations were slightly stronger among boys. Postnatal exposure to acetaminophen was not associated with ASC or ADHD symptoms. These results replicate previous work and support providing clear information to pregnant women and their partners about potential long-term risks of acetaminophen use.
KW - Acetaminophen
KW - Paracetamol
KW - Pregnancy
KW - Autism
KW - Attention-deficit
KW - hyperactivity disorder
KW - WELL-BEING ASSESSMENT
KW - BEHAVIORAL-PROBLEMS
KW - PARACETAMOL
KW - DISORDERS
KW - PREGNANCY
KW - CHILDREN
U2 - 10.1007/s10654-021-00754-4
DO - 10.1007/s10654-021-00754-4
M3 - Journal article
C2 - 34046850
VL - 36
SP - 993
EP - 1004
JO - European Journal of Epidemiology
JF - European Journal of Epidemiology
SN - 0393-2990
ER -
ID: 271753636