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. 2017 Nov;140(5):e20163840.
doi: 10.1542/peds.2016-3840.

Prenatal Exposure to Acetaminophen and Risk of ADHD

Eivind Ystrom  1   2   3 , Kristin Gustavson  4   2 , Ragnhild Eek Brandlistuen  4 , Gun Peggy Knudsen  4 , Per Magnus  4   5 , Ezra Susser  6   7 , George Davey Smith  8 , Camilla Stoltenberg  4   9 , Pål Surén  4 , Siri E Håberg  4 , Mady Hornig  6 , W Ian Lipkin  6 , Hedvig Nordeng  4   3 , Ted Reichborn-Kjennerud  4   5
Affiliations

Prenatal Exposure to Acetaminophen and Risk of ADHD

Eivind Ystrom et al. Pediatrics. 2017 Nov.

Abstract

Objectives: To estimate the association between maternal use of acetaminophen during pregnancy and of paternal use before pregnancy with attention-deficit/hyperactivity disorder (ADHD) in offspring while adjusting for familial risk for ADHD and indications of acetaminophen use.

Methods: Diagnoses were obtained from the Norwegian Patient Registry for 112 973 offspring from the Norwegian Mother and Child Cohort Study, including 2246 with ADHD. We estimated hazard ratios (HRs) for an ADHD diagnosis by using Cox proportional hazard models.

Results: After adjusting for maternal use of acetaminophen before pregnancy, familial risk for ADHD, and indications of acetaminophen use, we observed a modest association between any prenatal maternal use of acetaminophen in 1 (HR = 1.07; 95% confidence interval [CI] 0.96-1.19), 2 (HR = 1.22; 95% CI 1.07-1.38), and 3 trimesters (HR = 1.27; 95% CI 0.99-1.63). The HR for more than 29 days of maternal acetaminophen use was 2.20 (95% CI 1.50-3.24). Use for <8 days was negatively associated with ADHD (HR = 0.90; 95% CI 0.81-1.00). Acetaminophen use for fever and infections for 22 to 28 days was associated with ADHD (HR = 6.15; 95% CI 1.71-22.05). Paternal and maternal use of acetaminophen were similarly associated with ADHD.

Conclusions: Short-term maternal use of acetaminophen during pregnancy was negatively associated with ADHD in offspring. Long-term maternal use of acetaminophen during pregnancy was substantially associated with ADHD even after adjusting for indications of use, familial risk of ADHD, and other potential confounders.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
The figure depicts the Nelson-Aalen cumulative hazard estimate and the estimated proportion of children receiving an ADHD diagnosis by age after birth.
See this image and copyright information in PMC

Comment in

References

    1. Lupattelli A, Spigset O, Twigg MJ, et al. . Medication use in pregnancy: a cross-sectional, multinational web-based study. BMJ Open. 2014;4(2):e004365. - PMC - PubMed
    1. Werler MM, Mitchell AA, Hernandez-Diaz S, Honein MA. Use of over-the-counter medications during pregnancy. Am J Obstet Gynecol. 2005;193(3, pt 1):771–777 - PubMed
    1. Levy G, Garrettson LK, Soda DM. Letter: evidence of placental transfer of acetaminophen. Pediatrics. 1975;55(6):895. - PubMed
    1. Brandlistuen RE, Ystrom E, Nulman I, Koren G, Nordeng H. Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled cohort study. Int J Epidemiol. 2013;42(6):1702–1713 - PMC - PubMed
    1. Liew Z, Ritz B, Rebordosa C, Lee PC, Olsen J. Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA Pediatr. 2014;168(4):313–320 - PubMed

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