Ji Y, Azuine RE, Zhang Y, Hou W, Hong X, Wang G, Riley A,
Pearson C, Zuckerman B, Wang X. Association of Cord Plasma Biomarkers of In Utero
Acetaminophen Exposure With Risk of Attention-Deficit/Hyperactivity
Disorder and Autism Spectrum Disorder in Childhood. JAMA Psychiatry. 2019 Oct
30:1-11. doi:10.1001/jamapsychiatry.2019.3259. [Epub ahead of print]
Abstract
IMPORTANCE:
Prior studies have raised concern about maternal
acetaminophen use during pregnancy and increased risk of
attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder
(ASD) in their children; however, most studies have relied on maternal
self-report.
OBJECTIVE:
To examine the prospective associations between cord plasma
acetaminophen metabolites and physician-diagnosed ADHD, ASD, both ADHD and ASD,
and developmental disabilities (DDs) in childhood.
DESIGN, SETTING, AND PARTICIPANTS:
This prospective cohort study analyzed 996 mother-infant
dyads, a subset of the Boston Birth Cohort, who were enrolled at birth and
followed up prospectively at the Boston Medical Center from October 1, 1998, to
June 30, 2018.
EXPOSURES:
Three cord acetaminophen metabolites (unchanged
acetaminophen, acetaminophen glucuronide, and
3-[N-acetyl-l-cystein-S-yl]-acetaminophen) were measured in archived cord
plasma samples collected at birth.
MAIN OUTCOMES AND MEASURES:
Physician-diagnosed ADHD, ASD, and other DDs as documented
in the child's medical records.
RESULTS:
Of 996 participants (mean [SD] age, 9.8 [3.9] years; 548
[55.0%] male), the final sample included 257 children (25.8%) with ADHD only,
66 (6.6%) with ASD only, 42 (4.2%) with both ADHD and ASD, 304 (30.5%) with
other DDs, and 327 (32.8%) who were neurotypical. Unchanged acetaminophen
levels were detectable in all cord plasma samples. Compared with being in the
first tertile, being in the second and third tertiles of cord acetaminophen
burden was associated with higher odds of ADHD diagnosis (odds ratio [OR] for
second tertile, 2.26; 95% CI, 1.40-3.69; OR for third tertile, 2.86; 95% CI,
1.77-4.67) and ASD diagnosis (OR for second tertile, 2.14; 95% CI, 0.93-5.13;
OR for third tertile, 3.62; 95% CI, 1.62-8.60). Sensitivity analyses and
subgroup analyses found consistent associations between acetaminophen buden and
ADHD and acetaminophen burden and ASD across strata of potential confounders,
including maternal indication, substance use, preterm birth, and child age and
sex, for which point estimates for the ORs vary from 2.3 to 3.5 for ADHD and
1.6 to 4.1 for ASD.
CONCLUSIONS AND RELEVANCE:
Cord biomarkers of fetal exposure to acetaminophen were
associated with significantly increased risk of childhood ADHD and ASD in a
dose-response fashion. Our findings support previous studies regarding the
association between prenatal and perinatal acetaminophen exposure and childhood
neurodevelopmental risk and warrant additional investigations.
Courtesy of: https://www.medscape.com/viewarticle/920617
https://childnervoussystem.blogspot.com/2017/06/prenatal-fever-and-autism-risk.html
https://childnervoussystem.blogspot.com/2016/01/maternal-antidepressants-and-autism.html
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