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Association of Acetaminophen Use During Pregnancy With Behavioral Problems in Childhood: Evidence Against Confounding

Evie Stergiakouli1, Anita Thapar2, George Davey Smith1

  • 1Medical Research Council (MRC) Integrative Epidemiology Unit (IEU) at the University of Bristol, University of Bristol, Bristol, United Kingdom.

JAMA Pediatrics
|August 18, 2016
PubMed

Insights

Prenatal acetaminophen (paracetamol) use in mothers is linked to increased behavioral problems in children, including conduct issues and hyperactivity. These associations persist even after accounting for other factors, suggesting a direct link.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Public Health

Background:

  • Acetaminophen (paracetamol) is widely used by pregnant women.
  • Previous research suggests a link between prenatal acetaminophen exposure and abnormal fetal neurodevelopment.
  • Potential confounding factors, such as unmeasured behavioral influences, require investigation.

Purpose of the Study:

  • To investigate the association between offspring behavioral problems and maternal prenatal acetaminophen use.
  • To examine the relationship between offspring behavior and maternal postnatal and partner's acetaminophen use.
  • To determine if unmeasured behavioral or social factors confound the association between prenatal acetaminophen use and child behavior.

Main Methods:

  • Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort.
  • Inclusion of 7796 mothers and their children and partners.
  • Assessment of acetaminophen use via questionnaires during pregnancy and at 61 months postpartum.
  • Evaluation of child behavioral problems using the Strengths and Difficulties Questionnaire (SDQ) at age 7.

Main Results:

  • Maternal prenatal acetaminophen use was associated with increased odds of conduct problems and hyperactivity.
  • Acetaminophen use at 32 weeks of gestation also correlated with emotional symptoms and total difficulties.
  • No significant associations were found for maternal postnatal or partner's acetaminophen use.
  • Associations between prenatal exposure and behavioral problems remained consistent after adjusting for postnatal or partner's use.

Conclusions:

  • Prenatal acetaminophen exposure in mothers is linked to a higher risk of various behavioral difficulties in children.
  • The observed associations are unlikely to be explained by unmeasured behavioral or social confounders.
  • Further research is needed to confirm these findings and elucidate underlying mechanisms.
Abstract

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