Baker Brennan H, Burris Heather H, Bloomquist Tessa R, Boivin Amélie, Gillet Virginie, Larouche Annie, Takser Larissa, Bellenger Jean-Philippe, Pasquier Jean-Charles, Baccarelli Andrea A
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States.
Department of Pediatrics, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States.
Front Pediatr. 2022 Apr 5;10:828089. doi: 10.3389/fped.2022.828089. eCollection 2022.
The small number of studies examining the association of prenatal acetaminophen with birth outcomes have all relied on maternal self-report. It remains unknown whether prenatal acetaminophen exposure measured in a biological specimen is associated with birth outcomes.
To investigate the association of acetaminophen measured in meconium with birthweight, gestational age, preterm birth, size for gestational age, gestational diabetes, preeclampsia, and high blood pressure.
This birth cohort from Sherbrooke, QC, Canada, included 773 live births. Mothers with no thyroid disease enrolled at their first prenatal care visit or delivery. Acetaminophen was measured in meconium for 393 children at delivery. We tested associations of prenatal acetaminophen with birthweight, preterm birth, gestational age, small and large for gestational age, gestational diabetes, preeclampsia, and high blood pressure. We imputed missing data multiple imputation and used inverse probability weighting to account for confounding and selection bias.
Acetaminophen was detected in 222 meconium samples (56.5%). Prenatal acetaminophen exposure was associated with decreased birthweight by 136 g (β = -136; 95% CI [-229, -43]), 20% increased weekly hazard of delivery (hazard ratio = 1.20; 95% CI [1.00, 1.43]), and over 60% decreased odds of being born large for gestational age (odds ratio = 0.38; 95% CI [0.20, 0.75]). Prenatal acetaminophen was not associated with small for gestational age, preterm birth, or any pregnancy complications.
Prenatal acetaminophen was associated with adverse birth outcomes. Although unobserved confounding and confounding by indication are possible, these results warrant further investigation into adverse perinatal effects of prenatal acetaminophen exposure.
少数研究产前对乙酰氨基酚与出生结局之间关联的研究均依赖于母亲的自我报告。通过生物样本检测到的产前对乙酰氨基酚暴露是否与出生结局相关尚不清楚。
研究胎粪中检测到的对乙酰氨基酚与出生体重、胎龄、早产、小于胎龄儿、大于胎龄儿、妊娠期糖尿病、先兆子痫和高血压之间的关联。
这项来自加拿大魁北克省舍布鲁克的出生队列研究纳入了773例活产儿。无甲状腺疾病的母亲在首次产前检查或分娩时登记入组。分娩时对393名儿童的胎粪进行了对乙酰氨基酚检测。我们测试了产前对乙酰氨基酚与出生体重、早产、胎龄、小于胎龄儿和大于胎龄儿、妊娠期糖尿病、先兆子痫和高血压之间的关联。我们采用多重填补法填补缺失数据，并使用逆概率加权法来控制混杂因素和选择偏倚。
在222份胎粪样本（56.5%）中检测到了对乙酰氨基酚。产前对乙酰氨基酚暴露与出生体重降低136克相关（β=-136；95%可信区间[-229，-43]），每周分娩风险增加20%（风险比=1.20；95%可信区间[1.00，1.43]），大于胎龄儿出生几率降低60%以上（优势比=0.38；95%可信区间[0.20，0.75]）。产前对乙酰氨基酚与小于胎龄儿、早产或任何妊娠并发症无关。
产前对乙酰氨基酚与不良出生结局相关。尽管可能存在未观察到的混杂因素和指征性混杂，但这些结果值得进一步研究产前对乙酰氨基酚暴露的不良围产期影响。
