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Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder

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Název: Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder
Autoři: Damkier, Per, Gram, Erika, Ceulemans, Michael, Panchaud, Alice, Cleary, Brian, Chambers, Christina, Weber-Schoendorfer, Corinna, Kennedy, Debra, Hodson, Ken, Grant, Kimberly, Diav-Citrin, Orna, Obican, Sarah, Shechtman, Svetlana, Alwan, Sura
Zdroj: Obstetrics and Gynecology, 145, 2, pp. 168-176
Informace o vydavateli: Ovid Technologies (Wolters Kluwer Health), 2024.
Rok vydání: 2024
Témata: EXPOSURES, Autism Spectrum Disorder, Prenatal Exposure Delayed Effects/chemically induced, PRENATAL USE, Non-Narcotic/adverse effects, Attention Deficit Disorder with Hyperactivity/drug therapy, Autism Spectrum Disorder/chemically induced, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, CHILD IQ, IQ health - Radboud University Medical Center, DRUGS, Humans, COHORT, Child, Obstetrics & Reproductive Medicine, Acetaminophen, RISK, Analgesics, Science & Technology, HERITABILITY, 3215 Reproductive medicine, Obstetrics & Gynecology, Analgesics, Non-Narcotic, Attention Deficit Disorder with Hyperactivity, Prenatal Exposure Delayed Effects, 1114 Paediatrics and Reproductive Medicine, Female, Life Sciences & Biomedicine, CHRONIC PAIN, Acetaminophen/adverse effects
Popis: Acetaminophen is a common over-the-counter medication that recently gained substantial media attention regarding its use by pregnant individuals. In this clinical perspective, we discuss the strengths and limitations of the published literature on the effect of maternal acetaminophen use in pregnancy on the child's risk of developing attention-deficit and hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Studies included were specifically selected on the basis of the quality and validity of ADHD or ASD outcome definitions. From a total of 56 identified studies, commentaries, and editorials of relevance, we critically reviewed nine studies with original data that satisfied our inclusion criteria and three meta-analyses. Most studies that have reported positive findings are difficult to interpret because they have important biases, notably a high degree of selection bias, variability in selection and adjustment for various potential confounders, and unmeasured familial confounding. When unobserved familial confounding through sibling analysis was controlled for, associations weakened substantially. This suggests that residual confounding from shared genetic and environmental factors may have caused an upward bias in the original observations. According to the current scientific evidence, in utero exposure to acetaminophen is unlikely to confer a clinically important increased risk of childhood ADHD or ASD. The current level of evidence does not warrant changes to clinical guidelines on the treatment of fever or pain in pregnancy. Prospective research designed to account for familial and psychosocial environmental factors related to both maternal use of acetaminophen and children's neurodevelopment should be undertaken.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1873-233X
0029-7844
DOI: 10.1097/aog.0000000000005802
DOI: 10.48620/78874
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/39637384
https://hdl.handle.net/2066/315712
https://portal.findresearcher.sdu.dk/da/publications/449b9743-50d5-41cd-9426-8b66046e7b81
https://doi.org/10.1097/AOG.0000000000005802
Přístupové číslo: edsair.doi.dedup.....2a50fc44d4578cfa33fc1b98b8cfa4cc
Databáze: OpenAIRE
Popis
Abstrakt:Acetaminophen is a common over-the-counter medication that recently gained substantial media attention regarding its use by pregnant individuals. In this clinical perspective, we discuss the strengths and limitations of the published literature on the effect of maternal acetaminophen use in pregnancy on the child's risk of developing attention-deficit and hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Studies included were specifically selected on the basis of the quality and validity of ADHD or ASD outcome definitions. From a total of 56 identified studies, commentaries, and editorials of relevance, we critically reviewed nine studies with original data that satisfied our inclusion criteria and three meta-analyses. Most studies that have reported positive findings are difficult to interpret because they have important biases, notably a high degree of selection bias, variability in selection and adjustment for various potential confounders, and unmeasured familial confounding. When unobserved familial confounding through sibling analysis was controlled for, associations weakened substantially. This suggests that residual confounding from shared genetic and environmental factors may have caused an upward bias in the original observations. According to the current scientific evidence, in utero exposure to acetaminophen is unlikely to confer a clinically important increased risk of childhood ADHD or ASD. The current level of evidence does not warrant changes to clinical guidelines on the treatment of fever or pain in pregnancy. Prospective research designed to account for familial and psychosocial environmental factors related to both maternal use of acetaminophen and children's neurodevelopment should be undertaken.
ISSN:1873233X
00297844
DOI:10.1097/aog.0000000000005802