Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160 - 3° andar, Pelotas, RS, 96020-220, Brazil.
School of Nursing and Public Health, Universidade Federal de Pelotas, Pelotas, Brazil.
BMC Psychiatry. 2018 Nov 20;18(1):368. doi: 10.1186/s12888-018-1942-1.
Longitudinal studies have consistently reported that prenatal exposure to acetaminophen can to lead to an increased risk of attention deficit-hyperactivity disorder during childhood. This study aimed to investigate the association between intrauterine exposure to acetaminophen and the presence of emotional and behavioral problems at the ages of 6 and 11 years in a low-middle income country.
We performed a prospective longitudinal population-based study using data from the 2004 Pelotas birth cohort. From the 4231 initial cohort participants, 3722 and 3566 children were assessed at 6 and 11 years of age, respectively. The outcomes were assessed using the parent version of Strengths and Difficulties Questionnaire (SDQ). The cut-off points established for the Brazilian population were used to categorize the outcomes. Crude and adjusted odds ratio were obtained through logistic regression.
Acetaminophen was used by 27.5% (95% confidence interval [CI]: 26.1-28.9) of the mothers at least once during pregnancy. The prevalence of emotional problems at 6 and 11 years was 13.6 and 19.9%, respectively. For hyperactivity problems, prevalence was 13.9 and 16.1%, respectively. Intrauterine exposure to acetaminophen increased the odds of having emotional (odds ratio [OR] = 1.47; 95% CI: 1.07-2.02) and hyperactivity/inattention (OR = 1.42; 95% CI: 1.06-1.92) problems in 6-year-old boys. At the age of 11, a small decrease in the effect was observed for both outcomes after adjustment: OR = 1.31 (95% CI: 0.99-1.73) for emotional problems and OR = 1.25 (95% CI: 0.95-1.65) for hyperactivity/inattention in boys. No association for any phenotypes at both ages was observed for girls.
The effect of intrauterine exposure to acetaminophen in emotional and hyperactivity symptoms was dependent on sex in a Brazilian cohort. While it seemed to be important for boys, mainly at 6 years of age, for girls, no association was observed.
纵向研究一致报告称，产前接触扑热息痛会导致儿童时期注意力缺陷多动障碍的风险增加。本研究旨在调查中低收入国家内，子宫内暴露于扑热息痛与 6 至 11 岁儿童出现情绪和行为问题之间的关联。
我们使用来自 2004 年佩洛塔斯出生队列的前瞻性纵向人群基础研究数据进行了这项研究。在最初的 4231 名队列参与者中，分别有 3722 名和 3566 名儿童在 6 岁和 11 岁时接受了评估。使用父母版 Strengths and Difficulties Questionnaire (SDQ) 评估结果。使用为巴西人群确定的临界值对结果进行分类。通过逻辑回归获得粗比值比和调整比值比。
母亲在怀孕期间至少使用过一次扑热息痛的比例为 27.5%（95%置信区间[CI]：26.1-28.9）。6 岁和 11 岁时情绪问题的患病率分别为 13.6%和 19.9%。多动问题的患病率分别为 13.9%和 16.1%。子宫内接触扑热息痛会增加 6 岁男孩出现情绪（比值比[OR] = 1.47；95%CI：1.07-2.02）和多动/注意力不集中（OR = 1.42；95%CI：1.06-1.92）问题的几率。在 11 岁时，两个结局的调整后效应均略有下降：男孩情绪问题的 OR = 1.31（95%CI：0.99-1.73），多动/注意力不集中的 OR = 1.25（95%CI：0.95-1.65）。对于女孩，在这两个年龄阶段，任何表型都没有观察到相关性。
在巴西队列中，子宫内接触扑热息痛对情绪和多动症状的影响取决于性别。虽然对于男孩来说似乎很重要，主要是在 6 岁时，但对于女孩来说，没有观察到相关性。
