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Intrauterine Exposure to Acetaminophen and Adverse Developmental Outcomes: Epidemiological Findings and Methodological Issues

  • SUSCEPTIBILITY FACTORS IN ENVIRONMENTAL HEALTH (Z LIEW AND K POLLITT, SECTION EDITORS)
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Abstract

Purpose of Review

Acetaminophen (or paracetamol) is one of the most commonly used medications during pregnancy. We reviewed recent epidemiological evidence regarding intrauterine exposure to acetaminophen and risk for asthma, neurodevelopment disorders, and reproductive health in childhood.

Recent Findings

An increasing number of cohort studies have suggested that maternal use of acetaminophen during pregnancy was associated with increased risk for asthma; neurodevelopmental disorders, especially ADHD and behavioral problems; and genital malformations in the offspring. Oxidative stress and inflammation or endocrine effects are plausible shared biological mechanisms for the exposure to influence multiple developmental outcomes. We discussed methodological challenges that can threaten the validity of these observational data, including confounding and measurement errors. Novel statistical methods and research designs that can be used to mitigate these issues were introduced.

Summary

Given the high prevalence of use, findings regarding intrauterine exposure to acetaminophen on multiple child health outcomes raise concerns. Research on causal and non-causal mechanisms that might explain these associations should be a priority.

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Change history

  • 14 January 2021

    Springer Nature’s version of this paper was updated to correct a typo found in the body texts.

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Authors and Affiliations

  1. Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA

    Zeyan Liew

  2. Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, USA

    Zeyan Liew

  3. Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark

    Andreas Ernst

  4. Department of Urology, Aarhus University Hospital, Aarhus, Denmark

    Andreas Ernst

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  1. Zeyan Liew
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Liew, Z., Ernst, A. Intrauterine Exposure to Acetaminophen and Adverse Developmental Outcomes: Epidemiological Findings and Methodological Issues. Curr Envir Health Rpt 8, 23–33 (2021). https://doi.org/10.1007/s40572-020-00301-5

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