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Maternal Biomarkers of Acetaminophen Use and Offspring Attention Deficit Hyperactivity Disorder
Yuelong Ji1, Anne W Riley2, Li-Ching Lee3,4
1Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA. yji7@jhu.edu.
Insights
Maternal acetaminophen use during pregnancy, measured via biomarkers, is linked to an increased risk of attention deficit hyperactivity disorder (ADHD) in children. This association appears dose-responsive and specific to ADHD.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Pharmacology
Background:
- Previous research indicated a potential link between self-reported maternal acetaminophen use and offspring attention deficit hyperactivity disorder (ADHD).
- The reliability of self-reported data necessitates objective measures to confirm associations.
- Understanding prenatal exposure risks is crucial for child neurodevelopmental outcomes.
Purpose of the Study:
- To prospectively investigate the association between maternal plasma biomarkers of acetaminophen intake and offspring ADHD diagnosis.
- To determine if a dose-response relationship exists between acetaminophen biomarkers and ADHD risk.
- To assess the specificity of this association to ADHD compared to other neurodevelopmental disorders.
Main Methods:
- Analysis of 1180 children from the Boston Birth Cohort, with 188 diagnosed with ADHD.
- Measurement of maternal plasma acetaminophen biomarkers within 1-3 days postpartum.
- Use of multinomial logistic regression to estimate odds ratios, adjusting for covariates.
Main Results:
- Significant, positive, and dose-responsive associations were observed between maternal acetaminophen biomarkers and ADHD diagnosis.
- These associations remained significant after adjusting for acetaminophen use indications and other covariates.
- The observed associations were specific to ADHD and not found for other neurodevelopmental disorders.
Conclusions:
- Maternal acetaminophen biomarkers in early postpartum plasma are specifically associated with an increased risk of ADHD diagnosis in offspring.
- The findings support a potential biological link between acetaminophen exposure and ADHD development.
- Further clinical and mechanistic research is warranted to confirm and understand this association.
Abstract:
Previous studies have suggested a positive association between self-reported maternal acetaminophen use during pregnancy and risk of attention deficit hyperactivity disorder (ADHD) in offspring. We sought to examine the prospective association between maternal plasma biomarkers of acetaminophen intake and ADHD diagnosis in the offspring. This report analyzed 1180 children enrolled at birth and followed prospectively as part of the Boston Birth Cohort, including 188 with ADHD diagnosis based on electronic medical record review. Maternal biomarkers of acetaminophen intake were measured in plasma samples obtained within 1⁻3 days postpartum. Odds ratios for having ADHD diagnosis or other developmental disorders were estimated using multinomial logistic regression models, adjusting for pertinent covariables. Compared to neurotypical children, we observed significant positive dose-responsive associations with ADHD diagnosis for each maternal acetaminophen biomarker. These dose⁻responsive associations persisted after adjusting for indication of acetaminophen use and other pertinent covariates; and were specific to ADHD, rather than other neurodevelopmental disorders. In the stratified analyses, differential point estimates of the associations were observed across some strata of covariates. However, these differences were not statistically significant. Maternal acetaminophen biomarkers were specifically associated with increased risk of ADHD diagnosis in offspring. Additional clinical and mechanistic investigations are warranted.
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