Introduction: Acetaminophen is the only analgesic recommended by doctors for use in pregnancy. However, several studies have suggested a link between maternal acetaminophen use and adverse developmental outcomes in children, including attention deficit hyperactivity disorder and cerebral palsy. There exists a gap in knowledge in this area relating to the timing of acetaminophen use and overall cognitive development. We hypothesize that maternal prenatal acetaminophen use affects the neurodevelopment of offspring.
Methods: The current analysis included clinical and lifestyle data collected throughout pregnancy and at delivery from 2925 pregnancies in the Ontario Birth Study prospective cohort from 2013-2019 and data from the NIH Toolbox Early Childhood Cognition battery administered to children from index pregnancies aged 4 years old between 2018-2019 (N=282). The battery assesses attention, episodic memory, language, and cognitive flexibility, and the relationship between acetaminophen use and cognitive scores was determined using multivariable logistic regression. Potential confounders such as maternal demographics, alcohol consumption, parental smoking, and child’s gestational age at birth and sex were included in the model.
Results: 68% of mothers reported using acetaminophen in the 3 months before or during pregnancy, 39% reported use in the 3 months before pregnancy, 43% in early pregnancy, and 48% in late pregnancy. We did not observe an association between maternal acetaminophen intake any time before or during pregnancy, or specifically in early pregnancy, and low composite cognitive score of their offspring with adjusted odds ratios of 0.71 (95% confidence interval (CI) 0.36, 1.43, p=0.34) and 0.73 (95% CI 0.37, 1.43, p=0.36), respectively.
Conclusion: Whilst preliminary in nature, current data do not provide evidence to support a relationship of maternal acetaminophen use during pregnancy with adverse cognitive effects in children. Updated results based on expanded follow-up with approximately 350 children will be presented.
Julia Knight– Senior Scientist, Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital
Jasleen Arneja– Research Assistant, Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto
Ryan Seeto– Research Coordinator, Lunenfeld-Tanenabum Research Institute, Mount Sinai Hospital
Jennifer Brooks– Assistant Professor, Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto
Kellie Murphy– Vice-Chair of Research, Department of Obstetrics and Gynaecology, University of Toronto
Stephen Matthews– Professor, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital
Stephen Lye– Associate Director, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital
Rayjean Hung– Head, Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada