Parker William, Anderson Lauren G, Jones John P, Anderson Rachel, Williamson Lauren, Bono-Lunn Dillan, Konsoula Zacharoula
Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC 27599, USA.
WPLab, Inc., Durham, NC 27707, USA.
Children (Basel). 2023 Dec 29;11(1):44. doi: 10.3390/children11010044.
Based on available data that include approximately 20 lines of evidence from studies in laboratory animal models, observations in humans, correlations in time, and pharmacological/toxicological considerations, it has been concluded without reasonable doubt and with no evidence to the contrary that exposure of susceptible babies and children to acetaminophen (paracetamol) induces many, if not most, cases of autism spectrum disorder (ASD). However, the relative number of cases of ASD that might be induced by acetaminophen has not yet been estimated. Here, we examine a variety of evidence, including the acetaminophen-induced reduction of social awareness in adults, the prevalence of ASD through time, and crude estimates of the relative number of ASD cases induced by acetaminophen during various periods of neurodevelopment. We conclude that the very early postpartum period poses the greatest risk for acetaminophen-induced ASD, and that nearly ubiquitous use of acetaminophen during early development could conceivably be responsible for the induction in the vast majority, perhaps 90% or more, of all cases of ASD. Despite over a decade of accumulating evidence that acetaminophen is harmful for neurodevelopment, numerous studies demonstrate that acetaminophen is frequently administered to children in excess of currently approved amounts and under conditions in which it provides no benefit. Further, studies have failed to demonstrate long-term benefits of acetaminophen for the pediatric population, leaving no valid rationale for continued use of the drug in that population given its risks to neurodevelopment.
基于现有数据，这些数据包括来自动物实验模型研究的约20条证据、对人类的观察、时间上的相关性以及药理学/毒理学方面的考量，已经确凿无疑地得出结论，且没有相反证据表明，易受影响的婴儿和儿童接触对乙酰氨基酚（扑热息痛）会引发许多（即便不是大多数）自闭症谱系障碍（ASD）病例。然而，由对乙酰氨基酚可能引发的ASD病例的相对数量尚未得到估算。在此，我们审视了各种证据，包括对乙酰氨基酚导致成年人社交意识降低、ASD随时间的患病率，以及对神经发育不同阶段由对乙酰氨基酚引发的ASD病例相对数量的粗略估计。我们得出结论，产后极早期对乙酰氨基酚引发ASD的风险最大，而且在发育早期几乎普遍使用对乙酰氨基酚可能是绝大多数（或许90%或更多）ASD病例发病的原因。尽管十多年来不断有证据表明对乙酰氨基酚对神经发育有害，但众多研究表明，对乙酰氨基酚经常以超过目前批准剂量的量给儿童服用，且在并无益处的情况下使用。此外，研究未能证明对乙酰氨基酚对儿科人群有长期益处，鉴于其对神经发育有风险，在该人群中继续使用该药已没有合理依据。
