Prenatal Acetaminophen (Paracetamol) Use and the Risk of Autism and/or Attention-Deficit/Hyperactivity Disorder Among Sibling-Matched Cohorts

Does prenatal exposure to paracetamol (acetaminophen) increase the risk of autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) in offspring after accounting for unmeasured familial confounding?From an initial cohort of 708 020 mother-child pairs in Hong Kong (approximately 43.3% with prenatal paracetamol exposure), a sibling-matched cohort was constructed of 124 333 children who were assessed for ASD and 97 285 for ADHD. Prenatal paracetamol exposure was not associated with an increased risk of either ASD or ADHD and these findings were consistent across paracetamol exposure timing, pattern, and dose.These findings provide important reassurance regarding the safety of indicated paracetamol use during pregnancy.

Corresponding Authors: Eric Yuk Fai Wan, PhD, Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 1/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Rd, Pokfulam, Hong Kong SAR, China (yfwan@hku.hk); and Ian Chi Kei Wong, PhD, Aston Centre of Excellence in Pharmacotherapy Optimisation and Pharmacoepidemiology Research, Aston Pharmacy School, Aston University, Aston Triangle, B4 7ET, Birmingham, United Kingdom (i.wong1@aston.ac.uk).

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