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    Does in utero exposure to acetaminophen increase behavior problems in children?

    Exposure to acetaminophen while in utero may increase the risk of behavioral problems in a child, according to results of a recent prospective study published in JAMA Pediatrics.

    Investigators collected and analyzed data from the Avon Longitudinal Study of Parents and Children, a prospective cohort, from February 2015 to March 2016. They studied 7796 mothers who were enrolled in the study from 1991 to 1992 along with their children and partners. Use of acetaminophen was assessed by completing a survey at 18 and 32 weeks of pregnancy and then when the child was aged 61 months. Behavioral problems were maternally reported using the Strengths and Difficulties Questionnaire (SDQ) when the child was aged 7 years.

    Prenatal acetaminophen use at 18 weeks (n = 4415; 53%) and 32 weeks of pregnancy (n = 3381; 42%) was tied to higher odds of having hyperactivity symptoms (risk ratio [RR], 1.31; 95% confidence interval [CI], 1.16-1.49) and conduct problems (RR, 1.42; 95% CI, 1.25-1.62). Acetaminophen use at 32 weeks was linked to higher odds of total difficulties (RR, 1.46; 95% CI, 1.21-1.77) and having emotional symptoms (RR, 1.29; 95% CI, 1.09-1.53). No association was found with maternal postnatal acetaminophen use (n = 6916; 89%) or partner acetaminophen use (n = 3454; 84%). Links between prenatal acetaminophen use and all SDQ domains were unchanged even after adjusting for postnatal use and partner use.

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    The researchers concluded that prenatal exposure to acetaminophen increases risk of many behavioral difficulties in children. The associations do not appear to be explainable through unmeasured behavioral or social factors. While the results could have practical implications, the researchers say that further study is needed to understand the mechanism and replicate their findings.

    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.


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