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Updated: Nov 29, 2025

Moderate Prenatal Alcohol Exposure and Quantification of Social Behavior in Adult Rats
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Behavioral Problems at Age 11 Years After Prenatal and Postnatal Exposure to Acetaminophen: Parent-Reported and

Kosuke Inoue, Beate Ritz, Andreas Ernst

    American Journal of Epidemiology
    |November 24, 2020
    PubMed

    Insights

    Prenatal acetaminophen exposure is linked to increased behavioral problems in children up to age 11. This includes total difficulties, internalizing, and externalizing behaviors, with risks rising with longer exposure duration.

    Area of Science:

    • Epidemiology
    • Developmental Psychology
    • Pharmacology

    Background:

    • Acetaminophen (paracetamol) is a widely used analgesic and antipyretic during pregnancy.
    • Previous research suggests potential links between prenatal acetaminophen exposure and adverse behavioral outcomes in early childhood.
    • The long-term effects and associations with postnatal exposure require further investigation.

    Purpose of the Study:

    • To investigate the associations between prenatal and postnatal acetaminophen exposure and behavioral problems in children at 11 years of age.
    • To utilize both parent and child-reported behavioral measures for a comprehensive assessment.
    • To examine the dose-response relationship between cumulative exposure duration and behavioral outcomes.

    Main Methods:

    • Utilized data from 40,934 mother-child pairs in the Danish National Birth Cohort (1996-2002).
    • Collected Strengths and Difficulties Questionnaire (SDQ) data from parents and children at 11-year follow-up.
    • Estimated risk ratios for behavioral problems (total difficulties, internalizing, externalizing) associated with prenatal and postnatal acetaminophen exposure.

    Main Results:

    • Prenatal acetaminophen exposure showed a 10%-40% increased risk for total difficulties, internalizing, and externalizing problems, with stronger associations for longer exposure.
    • Postnatal exposure was linked to a 16%-19% higher risk of parent-reported internalizing behaviors, but associations were weak for child-reported measures.
    • Moderate correlations were observed between parent- and child-reported SDQ scores, particularly for externalizing behaviors (r=0.59).

    Conclusions:

    • Findings corroborate existing evidence on prenatal acetaminophen exposure and behavioral issues, extending observations to early adolescence.
    • The study highlights the potential impact of prenatal exposure on child behavior development.
    • Further research is warranted to understand the mechanisms and clinical implications of these associations.

    Keywords:
    DNBCacetaminophenbehavioral problemsmultiple informants’ comparisonparacetamol

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