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Neurodevelopmental problems at 18 months among children exposed to paracetamol in
utero: a propensity score matched cohort study
#MMPMID27585674
Vlenterie R
; Wood ME
; Brandlistuen RE
; Roeleveld N
; van Gelder MM
; Nordeng H
Int J Epidemiol
2016[Dec]; 45
(6
): 1998-2008
PMID27585674
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BACKGROUND: Previous studies showed that children exposed to paracetamol during
fetal life might have an increased risk of neurodevelopmental problems. Since
paracetamol is one of the most commonly used medications during pregnancy, even
small increases in the risk of neurodevelopmental problems may have considerable
implications for public health. METHODS: Using data from the Norwegian Mother and
Child Cohort Study, we applied propensity score (PS) matching to examine
associations between prenatal paracetamol exposure and neurodevelopmental
problems among children at 18 months of age. Paracetamol use was classified into
short-term (< 28 days) and long-term (? 28 days) of exposure. RESULTS: Of the
51?200 pregnancies included in our study, 40.5% of mothers ( n ?=?20?749) used
paracetamol at least once during pregnancy. In the PS-matched analyses, long-term
paracetamol exposure during pregnancy was associated with communication problems
[odds ratio (OR): 1.38, 95% confidence interval (CI) 0.98-1.95) and delayed motor
milestone attainment (OR: 1.35, 95% CI 1.07-1.70). We did not observe increased
risks after short-term exposure. Sensitivity analyses for several indications
showed similar effects as the PS-matched analyses, suggesting no confounding by
indication. CONCLUSION: Long-term exposure to paracetamol in utero was associated
with modestly increased risks of motor milestone delay and impaired communication
skills among children at 18 months. Caution is warranted when considering
long-term use of paracetamol during pregnancy; however, women with severe pain
conditions should not be deprived of appropriate pharmacotherapy.
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