Abstract
AbstractThe 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.
Funder
UK Medical Research Council and Wellcome
CERN
UK National Institute of Health Senior Investigator
European Union’s Horizon 2020
University of Bristol and UK Medical Research Council
Danish National Research Foundation
Danish Regional Committees
Pharmacy Foundation
Egmont Foundation
March of Dimes Birth Defects Foundation
Health Foundation
Novo Nordisk Foundation
Lundbeck Foundation
Danish Medical Research Council
Innovationsfonden
Nordea Foundation
Aarhus Ideas
University of Copenhagen Strategic Grant
Danish Council for Independent Research
Italian Ministry of Health
Italian Medicines Agency
Erasmus Medical Center
Erasmus University Rotterdam
Netherlands Organization for Health Research and Development
Netherlands Organization for Scientific Research
Ministry of Health, Welfare, and Sport
Ministry of Youth and Families
NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation
Vici project
European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant
Instituto de Salud Carlos III
Generalitat de Catalunya-CIRIT
Fundació la Marató de TV3
Spanish Ministry of Science and Innovation
CERCA Program
Juan de la Cierva – Incorporación Postdoctoral Contract awarded by Ministry of Economy, Industry and Competitiveness
Miguel Servet-II contract
Cátedra Telefónica, Universidad de Oviedo
CIBERESP
Obra Social Cajastur/Fundación Liberbank
Department of Health of the Basque Government
Provincial Government of Gipuzkoa
European Union
Generalitat Valenciana: FISABIO
Alicia Koplowitz Foundation 2017
the Greek Ministry of Health
National Institute of Environmental Health Sciences
Publisher
Springer Science and Business Media LLC