Prenatal Paracetamol Exposure and Child Neurodevelopment: A Review

Details

• Personal Author:
  Bauer AZ ; Bornehag C-G ; Herbert MR ; Kriebel D ; Swan SH
• Description:
  Background: The non-prescription medication paracetamol (acetaminophen, APAP) is currently recommended as a safe pain and fever treatment during pregnancy. However, recent studies suggest a possible association between APAP use in pregnancy and offspring neurodevelopment. Objectives: To conduct a review of publications reporting associations between prenatal APAP use and offspring neurodevelopmental outcomes. Methods: Relevant sources were identified through a key word search of multiple databases (Medline, CINAHL, OVID and TOXNET) in September 2016. All English language observational studies of pregnancy APAP and three classes of neurodevelopmental outcomes (autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and intelligence quotient (IQ)) were included. One reviewer (AZB) independently screened all titles and abstracts, extracted and analyzed the data. Results: 64 studies were retrieved and 55 were ineligible. Nine prospective cohort studies fulfilled all inclusion criteria. Data pooling was not appropriate due to heterogeneity in outcomes. All included studies suggested an association between prenatal APAP exposure and the neurodevelopmental outcomes; ADHD, ASD, or lower IQ. Longer duration of APAP use was associated with increased risk. Associations were strongest for hyperactivity and attention-related outcomes. Little modification of associations by indication for use was reported. Conclusions: Together, these nine studies suggest an increased risk of adverse neurodevelopmental outcomes following prenatal APAP exposure. Further studies are urgently needed with; precise indication of use and exposure assessment of use both in utero and in early life. Given the current findings, pregnant women should be cautioned against indiscriminate use of APAP. These results have substantial public health implications. [Description provided by NIOSH]
• Subjects:
  Behavior Biopharmaceutics Database Mental Disorders Nervous System Nervous System Diseases Occupational Health Pregnancy Risk Assessment Risk Factors Safety

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• Keywords:
  Acetaminophen Activity Levels ADHD Analgesics APAP ASD ASDs Attention Deficit Hyperactivity Disorder Author Keywords: Paracetamol Autism Autism Spectrum Disorder Autism Spectrum Disorders Behavioral Disorders Central Nervous System Children Databases Developmental Disorders Drugs Hyperactivity Information Processing Information Retrieval Systems Intellectual Disabilities Medicinal Chemicals Neurodevelopment Neurohormones Neurological Disorders Pharmaceuticals Prenatal Exposure Risk Factors Systematic Reviews Therapeutic Agents

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• ISSN:
  0018-506X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; New York ; OSHA Region 1 ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  125-147
• Volume:
  101
• NIOSHTIC Number:
  nn:20055464
• Citation:
  Horm Behav 2018 May; 101:125-147
• Contact Point Address:
  Ann Z. Bauer, Department of Public Health, University of Massachusetts, 1 University Avenue, Lowell, MA 01854, USA
• Email:
  Ann_Bauer@uml.edu
• CAS Registry Number:
  Acetaminophen (CAS RN 103-90-2)
• Federal Fiscal Year:
  2018
• Performing Organization:
  University of Massachusetts - Lowell
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Hormones and Behavior
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:244da24e53a089bd47481c0cba074361f838068a0bed47cb52251fdf5ffb874131de22626be3a7c1eabb638908925e5c20c808b7ba4aa340d746b40d13a0523e
• Download URL:
  https://stacks.cdc.gov/view/cdc/213303/cdc_213303_DS1.pdf
• File Type:
  [PDF - 848.16 KB ]