Related Experiment Video
Updated: Mar 15, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental problems at 18 months among children exposed to paracetamol in utero: a propensity score matched
Richelle Vlenterie1,2, Mollie E Wood2, Ragnhild Eek Brandlistuen1,2
1Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Insights
Long-term prenatal paracetamol use is linked to neurodevelopmental issues like delayed motor skills and communication problems in children. Short-term use showed no increased risks, suggesting caution with prolonged exposure during pregnancy.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Pharmacoepidemiology
Background:
- Prenatal exposure to paracetamol (acetaminophen) may increase neurodevelopmental problem risks in children.
- Paracetamol is widely used during pregnancy, making even small risk increases a public health concern.
Purpose of the Study:
- To investigate the association between prenatal paracetamol exposure and neurodevelopmental problems in infants.
- To differentiate risks associated with short-term versus long-term paracetamol use during gestation.
Main Methods:
- Utilized data from the Norwegian Mother and Child Cohort Study (N=51,200 pregnancies).
- Applied propensity score (PS) matching to analyze paracetamol exposure (short-term <28 days; long-term ≥28 days) and neurodevelopmental outcomes at 18 months.
- Conducted sensitivity analyses to assess confounding by indication.
Main Results:
- Long-term prenatal paracetamol exposure was associated with increased odds of communication problems (OR: 1.38, 95% CI 0.98-1.95) and delayed motor milestones (OR: 1.35, 95% CI 1.07-1.70).
- No significant risks were observed for short-term paracetamol exposure.
- Sensitivity analyses supported the PS-matched findings, indicating minimal confounding by indication.
Conclusions:
- Prolonged in utero exposure to paracetamol is linked to modest increases in motor and communication delays at 18 months.
- Caution is advised regarding long-term paracetamol use in pregnancy.
- Women with severe pain conditions require appropriate pharmacotherapy, even during pregnancy.
Background:
Previous studies showed that children exposed to paracetamol during fetal life might have an increased risk of neurodevelopmental problems. Since paracetamol is one of the most commonly used medications during pregnancy, even small increases in the risk of neurodevelopmental problems may have considerable implications for public health.
Methods:
Using data from the Norwegian Mother and Child Cohort Study, we applied propensity score (PS) matching to examine associations between prenatal paracetamol exposure and neurodevelopmental problems among children at 18 months of age. Paracetamol use was classified into short-term (< 28 days) and long-term (≥ 28 days) of exposure.
Results:
Of the 51 200 pregnancies included in our study, 40.5% of mothers ( n = 20 749) used paracetamol at least once during pregnancy. In the PS-matched analyses, long-term paracetamol exposure during pregnancy was associated with communication problems [odds ratio (OR): 1.38, 95% confidence interval (CI) 0.98-1.95) and delayed motor milestone attainment (OR: 1.35, 95% CI 1.07-1.70). We did not observe increased risks after short-term exposure. Sensitivity analyses for several indications showed similar effects as the PS-matched analyses, suggesting no confounding by indication.
Conclusion:
Long-term exposure to paracetamol in utero was associated with modestly increased risks of motor milestone delay and impaired communication skills among children at 18 months. Caution is warranted when considering long-term use of paracetamol during pregnancy; however, women with severe pain conditions should not be deprived of appropriate pharmacotherapy.
More Related Videos
15:27Construction of Vapor Chambers Used to Expose Mice to Alcohol During the Equivalent of all Three Trimesters of Human Development
Published on: July 13, 2014
07:36Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Related Concept Videos
01:07Teratogenicity
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:21Factors Affecting Drug Response: Overview
01:23Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
A study on guinea pigs examined the...