Prenatal exposure to acetaminophen and risk of ADHD
Open accessAbstract
OBJECTIVES: To estimate the association between maternal use of acetaminophen during pregnancy and of paternal use before pregnancy with attention-deficit/hyperactivity disorder (ADHD) in offspring while adjusting for familial risk for ADHD and indications of acetaminophen use. METHODS: Diagnoses were obtained from the Norwegian Patient Registry for 112 973 offspring from the Norwegian Mother and Child Cohort Study, including 2246 with ADHD. We estimated hazard ratios (HRs) for an ADHD diagnosis by using Cox proportional hazard models. RESULTS: After adjusting for maternal use of acetaminophen before pregnancy, familial risk for ADHD, and indications of acetaminophen use, we observed a modest association between any prenatal maternal use of acetaminophen in 1 (HR = 1.07; 95% confidence interval [CI] 0.96–1.19), 2 (HR = 1.22; 95% CI 1.07–1.38), and 3 trimesters (HR = 1.27; 95% CI 0.99–1.63). The HR for more than 29 days of maternal acetaminophen use was 2.20 (95% CI 1.50–3.24). Use for <8 days was negatively associated with ADHD (HR = 0.90; 95% CI 0.81–1.00). Acetaminophen use for fever and infections for 22 to 28 days was associated with ADHD (HR = 6.15; 95% CI 1.71–22.05). Paternal and maternal use of acetaminophen were similarly associated with ADHD. CONCLUSIONS: Short-term maternal use of acetaminophen during pregnancy was negatively associated with ADHD in offspring. Long-term maternal use of acetaminophen during pregnancy was substantially associated with ADHD even after adjusting for indications of use, familial risk of ADHD, and other potential confounders.
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Maternal prenatal acetaminophen shows a dose-response relation with ADHD.
“found a dose-response relationship between maternal prenatal use of acetaminophen and ADHD”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Ystrom et al., 2017
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“Another study, examining 113,000 offspring from the Norwegian Mother and Child Cohort Study and the Norwegian Patient Registry, including 2246 with ADHD, found a dose-response relationship between maternal prenatal use of acetaminophen and ADHD (Ystrom et al., 2017).”
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- Authors
- Ystrom, E., Gustavson, K., Brandlistuen, R. E., Knudsen, G. P., Magnus, P., Susser, E., Davey Smith, G., Stoltenberg, C., Surén, P., Håberg, S. E., Hornig, M., Lipkin, W. I., Nordeng, H., & Reichborn-Kjennerud, T.
- Affiliations
- Norwegian Institute of Public Health, Oslo, Norway;
- Norwegian Institute of Public Health (NO)
- New York State Psychiatric Institute (US)
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; and
- Columbia University (US)
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2017-11-01
- Volume
- 140
- Issue
- 5
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC5654387
- OpenAlex
- W2767021994
- Semantic Scholar
- 313f57fb0770305a35fd1fc1d1ed071122055a93
- Cited by
- 217
- References
- 44
- Citations by year
- 2026: 14 · 2025: 23 · 2024: 16 · 2023: 38 · 2022: 27 · 2021: 28 · 2020: 24 · 2019: 25 · 2018: 18 · 2017: 3
- FWCI
- 15.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Explore Bristol Research (acceptedVersion, other-oa)
- BIBSYS Brage (BIBSYS (Norway)) (acceptedVersion)
- Bristol Research (University of Bristol) (acceptedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- National Institutes of Health (n01es75558-11-0-1)
- National Institute of Neurological Disorders and Stroke (U01NS047537)
- National Institute of Environmental Health Sciences (N01 ES075558)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Keywords
- paracetamol, prenatal drug exposure, attention deficit hyperactivity disorder, maternal medication use
- MeSH terms
- Acetaminophen, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Drug Administration Schedule, Female, Humans, Infant, Male, Norway, Pregnancy, Prenatal Exposure Delayed Effects, Prospective Studies, Surveys and Questionnaires, Registries, Risk Factors, Cohort Studies, Analgesics, Non-Narcotic
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