Prenatal Acetaminophen May Increase Autism Symptoms in Boys Interview with:
Dr-Claudia-Avella-GarcíaClaudia Avella-García MD, MPH, PhD
ISGlobal – Institut de Salut Global Barcelona
Unitat Docent de Medicina Preventiva i Salut Publica H.Mar-UPF-ASPB What is the background for this study?

Response: Acetaminophen (paracetamol) is used by around half of all pregnant women in developed countries and is currently the recommended treatment for fever and pain during gestation. However, evidence linking exposure to this medication with negative changes in neurodevelopment has been coming to light, warranting further study. Therefore, our objective was to evaluate whether prenatal exposure to acetaminophen was adversely associated with child neurodevelopment at 1 and 5 years of age. For this reason, we evaluated 2644 mother-child pairs recruited during pregnancy as part of the INfancia y Medio Ambiente – Childhood and Environment (INMA) project, a Spanish general population-based cohort. We collected information on acetaminophen use prospectively up until week 32 of gestation. We evaluated neurodevelopment at 1 year of age using the Bayley Scales of Infant Development. At 5 years of age we applied a battery of tests evaluating different aspects of neurodevelopment including both cognitive and behavioural aspects. What are the main findings?

Response: Our main findings were that prenatal exposure to acetaminophen may increase autism spectrum symptoms in male children, as well as being harmful to attention function and increasing the risk of hyperactivity/impulsivity symptoms in both sexes. Furthermore, these findings appear to be dependent on the frequency of exposure. We did not document any associations with cognitive, motor or social development. What should readers take away from your report?

Response: Future research should use more precise exposure measurement (such as the exact dose consumed). They should also examine the potentially harmful effects of acetaminophen use in neonates and young children. It is necessary to assess the risk/benefit relationship of use both in pregnant women and in infants and to conduct risk /alternatives analyses. Finally, it is important to evaluate the mechanisms through which acetaminophen could be contributing to these harmful effects on neurodevelopment. What recommendations do you have for future research as a result of this study?

Response: Until further studies examining these aspects are concluded, there are no grounds for changing current treatment recommendations. Nevertheless, following the precautionary principle, it would be wise to minimize exposure during pregnancy, avoiding the use of acetaminophen if it is not needed. Thank you for your contribution to the community.


Claudia B. Avella-Garcia, Jordi Julvez, Joan Fortuny, Cristina Rebordosa, Raquel García-Esteban, Isolina Riaño Galán, Adonina Tardónf, Clara L. Rodríguez-Bernal, Carmen Iñiguez, Ainara Andiarena, Loreto Santa-Marina, Jordi Sunyer. Acetaminophen Use in Pregnancy and Neurodevelopment: Attention Function and Autism Spectrum Symptoms. International Journal of Epidemiology, 2016 DOI: 10.1093/ije/dyv

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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Last Updated on July 4, 2016 by Marie Benz MD FAAD