Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability

Area of Science:

• Neurodevelopmental disorders
• Pregnancy health
• Pediatric health

Background:

• Acetaminophen (paracetamol) is commonly used for pain and fever relief during pregnancy.
• Previous studies have suggested a potential link between prenatal acetaminophen exposure and increased risk of neurodevelopmental disorders in children.
• Clarifying this association is crucial for guiding clinical practice and ensuring maternal and child well-being.

Purpose of the Study:

• To investigate the association between acetaminophen use during pregnancy and the risk of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability in offspring.
• To differentiate medication effects from potential familial confounding factors.

Main Methods:

• A nationwide cohort study in Sweden included over 2.4 million children born between 1995 and 2019.
• Acetaminophen exposure was determined from antenatal and prescription records.
• Sibling control analysis was employed to account for shared genetic and environmental factors within families.

Main Results:

• Crude analyses showed marginally increased risks for autism, ADHD, and intellectual disability with prenatal acetaminophen exposure.
• However, sibling control analyses found no statistically significant association between acetaminophen use during pregnancy and the risk of these neurodevelopmental disorders.
• No dose-response relationship was observed in the sibling analyses.

Conclusions:

• Prenatal acetaminophen use is not associated with an increased risk of autism, ADHD, or intellectual disability in children.
• The findings suggest that familial confounding, rather than acetaminophen itself, may explain previously observed associations.
• This study provides robust evidence to support the continued use of acetaminophen for pain and fever management during pregnancy when medically indicated.