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Maternal use of acetaminophen during pregnancy and neurobehavioral problems in offspring at 3 years: A prospective
Kristin K Sznajder1, Douglas M Teti2, Kristen H Kjerulff1
1Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States of America.
Insights
Prenatal acetaminophen exposure is linked to sleep and attention problems in 3-year-olds. This common medication use during pregnancy warrants caution due to potential neurobehavioral effects in children.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Psychology
Background:
- Acetaminophen is a widely used medication during pregnancy globally.
- Emerging research suggests a link between prenatal acetaminophen exposure and neurobehavioral issues in children, including attention disorders.
- Limited data exists on these associations in preschool-aged children and the impact of prenatal stress.
Purpose of the Study:
- To investigate the association between prenatal acetaminophen exposure and neurobehavioral problems in offspring at age 3.
- To explore the potential confounding role of prenatal stress in this association.
Main Methods:
- Prospective cohort study (First Baby Study) with 2,423 mother-child pairs.
- Mothers reported medication use and prenatal stress during the third trimester.
- Child behavior assessed at age 3 using the Child Behavior Checklist (CBCL) 7-syndrome scale.
Main Results:
- Acetaminophen use during pregnancy was reported by 41.7% of women.
- Prenatal acetaminophen exposure was associated with higher scores in withdrawn, sleep, and attention problems.
- After adjusting for prenatal stress, sleep problems (aOR=1.23) and attention problems (aOR=1.21) remained significantly associated with prenatal acetaminophen exposure.
Conclusions:
- Findings support previous research linking prenatal acetaminophen to attention problems.
- A novel association with sleep problems at age 3 years was identified.
- Given the prevalence of acetaminophen use, these findings highlight public health concerns and suggest caution during pregnancy.
Background:
Acetaminophen is one of the most commonly used drugs during pregnancy globally. Recent studies have reported associations between prenatal exposure to acetaminophen and neurobehavioral problems in children, including attention-deficit hyperactivity disorders. Little research has investigated these associations in preschool-age children or the potential confounding effects of prenatal stress. The purpose of this study was to examine associations between prenatal acetaminophen exposure and offspring neurobehavioral problems at the age of 3 years, with a focus on the potentially confounding effects of prenatal stress.
Methods:
We used data from the First Baby Study, a prospective cohort study conducted in Pennsylvania, USA, with 2,423 mother-child pairs. Women reported medication use and completed a prenatal stress inventory during their third trimester. Child behavioral problems were measured at the age of 3 years, using the 7 syndrome scale scores from the Child Behavior Checklist (CBCL) for ages 1 ½ to 5.
Results:
There were 1,011 women (41.7%) who reported using acetaminophen during pregnancy. Children who were exposed to acetaminophen during pregnancy scored significantly higher on 3 of the 7 CBCL syndrome scales: withdrawn, sleep problems and attention problems. Scores on all 7 of the CBCL syndrome scales were significantly associated with prenatal stress. After adjustment for prenatal stress and other confounders, 2 syndrome scales remained significantly higher in children exposed to acetaminophen: sleep problems (aOR = 1.23, 95% CI = 1.01-1.51) and attention problems (aOR = 1.21, 95% CI = 1.01-1.45).
Conclusions:
These findings corroborate previous studies reporting associations between prenatal exposure to acetaminophen and attention problems in offspring and also show an association with sleep problems at age 3 years. Because use of acetaminophen during pregnancy is common, these results are of public health concern and suggest caution in the use of medications containing acetaminophen during pregnancy.
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