Prenatal acetaminophen use linked to ADHD symptoms in preschoolers

Use of acetaminophen during pregnancy was associated with sleep, attention, and behavioral problems in preschool-aged children in a recent study at Penn State College of Medicine.

The study, published in the journal, PLOS ONE, was led by Kristin Sznajder, PhD, MPH, assistant professor of public health sciences at Penn State University. Past studies have shown a relationship between prenatal exposure to acetaminophen and attention deficit/hyperactivity disorder (ADHD) in children. For this investigation, Sznajder and her colleagues sought to examine the associations between maternal acetaminophen use during pregnancy and neurobehavioral problems in three-year-old children, along with the effects of prenatal stress.

Researchers analyzed data from First Baby Study, which followed more than 2,400 mother-child pairs in Pennsylvania. During their pregnancies, mothers were surveyed on their medication use. At the age of three, researchers screened the child participants for neurobehavioral problems using the seven-syndrome scale from the Child Behavioral Checklist (CBCL). Researchers then added up scores from the CBCL to determine whether a child was emotionally reactive, withdrawn, depressed, anxious, aggressive, or struggled with sleep.

Of the participants, 41.7% of mothers reported using acetaminophen. Researchers found children exposed to acetaminophen during pregnancy were significantly more likely to struggle with sleep, attention, and connecting with others. Prenatal stress was associated with all CBCL scores. When scores were adjusted for prenatal stress and other cofounders, two syndrome scales continued to show associations with acetaminophen use: sleep problems and attention problems.

According to authors, these results correspond with findings from other studies, reinforcing evidence indicating a link between neurobehavioral problems and acetaminophen. However, Sznajder explained that more research is needed before official conclusions are made as to whether acetaminophen use is safe for pregnant patients.

"We should interpret these results with some degree of caution," Sznajder said in a statement. "Although acetaminophen is generally considered safe for use during pregnancy, data from multiple studies suggest that there could be effects on childhood development by its use. It's important we learn as much as we can about this subject so we can give expecting mothers data-driven recommendations to care for their children and themselves."