Hoover Rebecca M, Hayes V Autumn Gombert, Erramouspe John
College of Pharmacy, Idaho State University, Pocatello, ID, USA
College of Pharmacy, Idaho State University, Pocatello, ID, USA.
Ann Pharmacother. 2015 Dec;49(12):1357-61. doi: 10.1177/1060028015606469. Epub 2015 Sep 23.
To evaluate the effect of prenatal acetaminophen exposure on the future development of attention deficit/hyperactivity disorder (ADHD) in children.
Literature searches of MEDLINE (1975 to June 2015), International Pharmaceutical Abstracts (1975 to June 2015), and Cochrane Database (publications through June 2015) for prospective clinical trials assessing the relationship of prenatal acetaminophen exposure and the development of attention deficit disorders or hyperactivity.
Studies comparing self-reported maternal acetaminophen use during pregnancy to development of ADHD or ADHD-like behaviors in offspring between the ages of 3 and 12 years.
Four studies examining the effects of prenatal acetaminophen exposure on subsequent ADHD behaviors were identified. Of these, one early study found no link to ADHD behaviors while the other studies found statistically significant correlations with the most prominent being a study finding a higher risk for using ADHD medications (hazard ratio = 1.29; 95% CI, 1.15-1.44) or having ADHD-like behaviors at age 7 years as determined by the Strengths and Difficulties Questionnaire (risk ratio = 1.13; 95% CI, 1.01-1.27) in children whose mothers used acetaminophen during pregnancy.
While there does appear to be a mild correlation between prenatal acetaminophen use and the development of ADHD symptoms in children, current data do not provide sufficient evidence that prenatal acetaminophen exposure leads to development of ADHD symptoms late in life. Acetaminophen is a preferred option for pain management during pregnancy when compared with other medications such as nonsteroidal anti-inflammatory drugs or opioids for pyretic or pain relief.
评估孕期接触对乙酰氨基酚对儿童未来注意力缺陷多动障碍（ADHD）发展的影响。
对MEDLINE（1975年至2015年6月）、国际药学文摘（1975年至2015年6月）和Cochrane数据库（截至2015年6月的出版物）进行文献检索，以查找评估孕期接触对乙酰氨基酚与注意力缺陷障碍或多动发展之间关系的前瞻性临床试验。
比较自我报告的孕期母亲对乙酰氨基酚使用情况与3至12岁后代ADHD或ADHD样行为发展的研究。
确定了四项研究孕期接触对乙酰氨基酚对后续ADHD行为影响的研究。其中，一项早期研究未发现与ADHD行为有联系，而其他研究发现有统计学意义的相关性，最显著的是一项研究发现，母亲在孕期使用对乙酰氨基酚的儿童使用ADHD药物的风险更高（风险比=1.29；95%可信区间，1.15 - 1.44），或根据优势与困难问卷在7岁时出现ADHD样行为的风险更高（风险比=1.13；95%可信区间，1.01 - 1.27）。
虽然孕期使用对乙酰氨基酚与儿童ADHD症状发展之间似乎存在轻度相关性，但目前的数据并未提供充分证据表明孕期接触对乙酰氨基酚会导致晚年出现ADHD症状。与其他用于退热或止痛的药物（如非甾体抗炎药或阿片类药物）相比，对乙酰氨基酚是孕期疼痛管理的首选药物。
