Smith-Webb Rashida S, Barnard-Mayers Ruby, Werler Martha M, Parker Samantha E
Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
Front Pharmacol. 2023 Mar 2;14:1084781. doi: 10.3389/fphar.2023.1084781. eCollection 2023.
Acetaminophen, which is one of the most commonly used medications during pregnancy, has been linked to adverse neurodevelopmental outcomes among offspring during childhood. Less is known about associations with outcomes occurring later in adolescence. We conducted a follow-up study of children born between 1996 and 2002. Data on illnesses and medications, including acetaminophen, during pregnancy were collected through a standardized interview after delivery. Behavioral assessments were conducted at two subsequent time points, childhood (ages 5-10) and adolescence (ages 11-17). Outcomes examined included internalizing, externalizing, and total behavior problems based on the parent-completed Child Behavior Checklist (CBCL), the teacher-completed Teacher Report Form (TRF), and the youth-completed Youth Self Report (YSR, adolescent follow-up only). Adjusted linear regression models were used to calculate mean differences (MD) and 95% confidence intervals (95% CI) in T-scores comparing those with prenatal acetaminophen exposure to those without. Stabilized inverse probability weights were used to account for attrition. Among the 216 mother-child dyads with completed parent and teacher behavioral assessments at both childhood and adolescence, prenatal acetaminophen exposure was not associated with behavioral problems according to either parent or teacher assessments. Modest increases in externalizing and total behavior problems were observed according to youth report (MD: 1.9). Compared to associations observed during the childhood follow-up, associations at adolescence were attenuated according to parent-report. Reported associations between prenatal acetaminophen exposure and behavioral outcomes were not consistent over time nor between reporters.
对乙酰氨基酚是孕期最常用的药物之一，它与儿童期后代的不良神经发育结局有关。对于其与青春期后期出现的结局之间的关联，人们了解较少。我们对1996年至2002年出生的儿童进行了一项随访研究。通过产后标准化访谈收集孕期疾病和药物（包括对乙酰氨基酚）的数据。在随后的两个时间点进行行为评估，即儿童期（5至10岁）和青春期（11至17岁）。所检查的结局包括基于家长填写的儿童行为量表（CBCL）、教师填写的教师报告表（TRF）以及青少年填写的青少年自我报告（仅适用于青少年随访）的内化、外化和总行为问题。使用调整后的线性回归模型计算比较产前暴露于对乙酰氨基酚者与未暴露者的T分数的平均差异（MD）和95%置信区间（95%CI）。使用稳定的逆概率权重来处理失访问题。在216对在儿童期和青春期均完成家长和教师行为评估的母婴二元组中，根据家长或教师评估，产前暴露于对乙酰氨基酚与行为问题无关。根据青少年报告，外化和总行为问题有适度增加（MD：1.9）。与儿童期随访期间观察到的关联相比，青春期根据家长报告的关联减弱。所报告的产前暴露于对乙酰氨基酚与行为结局之间的关联在不同时间以及不同报告者之间并不一致。
