Acetaminophen (Paracetamol) Exposure During Pregnancy and Pubertal Development in Boys and Girls From a Nationwide Puberty Cohort

Abstract

This study explored the association between exposure to acetaminophen during pregnancy and pubertal development using data from 15,822 boys and girls in the longitudinal Puberty Cohort, nested within the Danish National Birth Cohort. Use of acetaminophen was reported 3 times during pregnancy and 6 months postpartum. In total, 54% of mothers indicated use at least once during pregnancy. Between 2012 and 2017, sons and daughters provided information on a wide range of pubertal milestones-including Tanner stages, axillary hair growth, and age at menarche or voice break and first ejaculation-every 6 months from 11 years of age until full sexual maturation. Data were analyzed using a regression model for interval-censored data, providing adjusted mean monthly differences in age at attaining the pubertal milestones according to intrauterine cumulative (weeks) and trimester-specific acetaminophen exposure. Our results suggested a tendency towards slightly earlier attainment of almost all studied markers of female pubertal development with increasing number of weeks of exposure (i.e., about 1.5-3 months earlier age at pubic hair, axillary hair, and acne development comparing unexposed with those prenatally exposed for more than 12 weeks). Male pubertal development had no strong association with acetaminophen exposure.

Figure 1.

Flow diagram of participants in the Puberty Cohort nested within the Danish National Birth Cohort (DNBC) (n = 15,822), Denmark, 2000–2017.

Figure 2.

Adjusted mean differences (months, 95% confidence intervals (CIs)) in age at attaining various pubertal milestones in boys according to number of weeks with exposure to acetaminophen during gestation, the Puberty Cohort, Denmark, 2012–2017.

Figure 3.

Adjusted mean differences (months, 95% confidence intervals (CIs)) in age at attaining various pubertal milestones in girls according to number of weeks with exposure to acetaminophen during gestation, the Puberty Cohort, Denmark, 2012–2017.

Figure 4.

Adjusted mean differences (months, 95% confidence intervals (CIs)) in age at attaining various pubertal milestones in boys according to trimester of exposure to acetaminophen during gestation, the Puberty Cohort, Denmark, 2012–2017.

Figure 5.

Adjusted mean differences (months, 95% confidence intervals (CIs)) in age at attaining various pubertal milestones in girls according to trimester of exposure to acetaminophen during gestation, the Puberty Cohort, Denmark, 2012–2017.