Systematic Review and Meta-Analysis: Acetaminophen Use During Pregnancy and the Risk of Neurodevelopmental Disorders...

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Pharmacoepidemiology

Background:

• Acetaminophen is widely used for pain and fever relief during pregnancy.
• Concerns exist regarding potential neurodevelopmental effects of prenatal drug exposure.
• Existing research on acetaminophen and neurodevelopmental disorders (NDDs) yields inconsistent findings.

Purpose of the Study:

• To systematically review and meta-analyze the association between prenatal acetaminophen exposure and the risk of NDDs in children.
• To quantify the risk of specific NDDs, including ADHD and ASD, following gestational acetaminophen use.

Main Methods:

• A comprehensive literature search was conducted across major databases and gray literature.
• Random-effects meta-analysis was used to pool odds ratios (OR) for various NDDs.
• Sensitivity analyses, including E-value and bias analysis, were performed to assess the robustness of findings.

Main Results:

• Sixteen studies involving millions of children were included.
• Prenatal acetaminophen exposure was associated with an increased risk of ADHD (ORpooled = 1.17).
• No significant association was found between gestational acetaminophen use and autism spectrum disorder (ASD).

Conclusions:

• Gestational acetaminophen exposure shows a small association with an increased risk of ADHD.
• The observed association for ADHD was attenuated in sensitivity analyses.
• Further robust studies are necessary to confirm these findings and understand potential mechanisms.