RT Journal Article
SR Electronic
T1 O-32 Prenatal exposure to acetamin-ophen and risk for attention defi-cit disorder (adhd): a systematic review and meta analysis
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP A15
OP A15
DO 10.1136/archdischild-2017-esdppp.32
VO 102
IS 10
A1 Reem
A1 Reif
A1 Levine
A1 Matok
YR 2017
UL http://adc.bmj.com/content/102/10/A15.1.abstract
AB Background Acetaminophen is the most commonly used analgesic and antipyretic medication during preg-nancy. Recent epidemiological studies have suggested a possible association between acetaminophen exposure in-utero and impaired paediatric neurological develop-ment, including hyperactive attention deficit (ADHD) and related disorders.Methods We conducted a systematic-review and me-ta-analysis to evaluate the risk for ADHD in children of women exposed to acetaminophen during pregnancy. We searched MEDLINE and EMBASE up to January 2017. We used meta-regression analysis to evaluate factors that may moderate this association. Reports of cohorts were pooled using random-effects models.Results Six cohort studies met our inclusion criteria. Among 76 146 mothers who reported acetaminophen use during pregnancy, acetaminophen was associated with an increased risk for ADHD (RR=1.33, 95% CI: 1.19–1.47, I2=77%), hyperactivity symptoms (RR=1.24, 95% CI: 1.02–1.46, I2=95%), and conduct disorders (RR=1.28; 95% CI, 1.05–1.52, I2=93%). Using meta-regression, we found that the association was greater and heterogeneity re-duced as child’s age at diagnosis increased (β=0.045, p=0.035, heterogeneity accounted for (R2)=65.98%).Conclusion This meta-analysis suggests that maternal acetaminophen use during pregnancy is associated with a higher risk for ADHD or related disorders. However, there is evidence of significant heterogeneity in the observed effect, and many of the studies suffer from significant lim-itations. These findings, together with additional recent evidence on teratogenicity of acetaminophen, warrants further investigation and consideration of public health actions.PROSPERO registry-CRD42017055827