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Analgesic drug use in pregnancy and neurodevelopment outcomes: an umbrella review

Janell Kwok1, Emily Luedecke1, Hildigunnur Anna Hall1

  • 1Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh EH8 9JZ, UK.

Neuroscience and Biobehavioral Reviews
|March 11, 2022
PubMed

Insights

Prenatal exposure to acetaminophen may increase the risk of attention-deficit/hyperactivity disorder (ADHD) in children. Minimizing acetaminophen use during pregnancy is recommended due to potential neurodevelopmental concerns.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Pharmacology

Background:

  • Emerging evidence links prenatal analgesic exposure to adverse child neurodevelopmental outcomes.
  • A comprehensive synthesis of existing evidence is crucial for clinical guidelines.
  • Reviews suggest a need for further investigation into specific drug-outcome associations.

Purpose of the Study:

  • To synthesize high-quality evidence on prenatal analgesic drug exposure and the risk of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) in children.
  • To provide a comprehensive overview of existing evidence to inform clinical practice.
  • To evaluate the association between maternal acetaminophen use during pregnancy and neurodevelopmental outcomes in offspring.

Main Methods:

  • An umbrella review methodology was employed, searching seven databases from inception to May 2021.
  • Included studies were systematic reviews and meta-analyses of any design.
  • Risk of bias and heterogeneity were assessed using AMSTAR 2 and GRADE criteria, with findings summarized via narrative synthesis.

Main Results:

  • Five systematic reviews and meta-analyses met the inclusion criteria.
  • All included reviews reported significant associations between maternal prenatal acetaminophen use and ADHD outcomes (risk ratio range: 1.08-1.34).
  • A potential dose-dependent relationship was observed, with timing and dosage identified as sources of heterogeneity.

Conclusions:

  • Findings suggest minimizing prenatal acetaminophen exposure due to the identified risk for ADHD outcomes.
  • Further research is warranted to explore potential interacting mechanisms linking acetaminophen use during pregnancy to neurodevelopmental outcomes.
  • This review highlights the importance of considering analgesic use during pregnancy and its potential impact on child neurodevelopment.

Keywords:
ADHDASDAcetaminophenAnalgesicsMedicationPregnancyUmbrella review

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