Liew Zeyan, Bach Cathrine Carlsen, Asarnow Robert F, Ritz Beate, Olsen Jørn
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), CA, USA.
Perinatal Epidemiology Research Unit, Aarhus University Hospital, Skejby, Denmark.
Int J Epidemiol. 2016 Dec 1;45(6):2009-2017. doi: 10.1093/ije/dyw296.
We studied 1491 mothers and children enrolled in the Danish National Birth Cohort (DNBC; 1996-2002). Prenatal paracetamol use was prospectively recorded in three telephone interviews. Trained psychologists assessed child's attention function using the Test of Everyday Attention for Children at Five (TEACh-5). Parents and preschool teachers completed Behaviour Rating Inventory of Executive Function (BRIEF) to assess executive functions. We estimated the differences of composite mean outcome scores, and odds ratios (OR) for subnormal attention or executive function (defined as 1 standard deviation below the mean), adjusting for maternal IQ, maternal mental health, indications for paracetamol use and other potential confounders.
First trimester use of paracetamol was associated with poorer attention scores in childhood [mean difference -0.34, 95% confidence interval (CI) -0.63, -0.05 for overall attention, and -0.25, 95% CI -0.50, 0.01 for selective attention]. Children prenatally exposed to paracetamol were also at a higher risk for subnormal overall attention (OR = 1.5, 95% CI 1.0, 2.5), selective attention difficulties (OR = 1.5, 95% CI 1.0, 2.4), and parent-rated subnormal executive function (metacognition index, OR = 1.5, 95% CI 0.9, 2.3). The risks for subnormal overall attention or executive function were elevated with longer duration of paracetamol use in pregnancy.
We found some evidence that maternal paracetamol use during pregnancy was associated with poorer attention and executive function in 5-year-olds.
我们研究了丹麦国家出生队列（DNBC；1996 - 2002年）中的1491名母亲和儿童。在三次电话访谈中前瞻性记录了孕期对乙酰氨基酚的使用情况。训练有素的心理学家使用儿童日常注意力测试（TEACh - 5）评估儿童的注意力功能。父母和幼儿园教师完成执行功能行为评定量表（BRIEF）以评估执行功能。我们估计了综合平均结果得分的差异，以及注意力或执行功能低于正常水平（定义为低于均值1个标准差）的比值比（OR），并对母亲智商、母亲心理健康状况、使用对乙酰氨基酚的指征以及其他潜在混杂因素进行了调整。
孕早期使用对乙酰氨基酚与儿童期注意力得分较低相关[总体注意力的平均差异为 - 0.34，95%置信区间（CI）为 - 0.63， - 0.05；选择性注意力的平均差异为 - 0.25，95%CI为 - 0.50，0.01]。产前暴露于对乙酰氨基酚的儿童在总体注意力低于正常水平（OR = 1.5，95%CI为1.0，2.5）、选择性注意力困难（OR = 1.5，95%CI为1.0，2.4）以及父母评定的执行功能低于正常水平（元认知指数，OR = 1.5，95%CI为0.9，2.3）方面的风险也更高。孕期使用对乙酰氨基酚的时间越长，总体注意力或执行功能低于正常水平的风险就越高。
我们发现一些证据表明，孕期母亲使用对乙酰氨基酚与5岁儿童注意力和执行功能较差有关。
