Prenatal exposure to acetaminophen and respiratory symptoms in the first year of life

Division of Epidemiology and Biostatistics, The University of Illinois, Chicago School of Public Health, Chicago, Illinois 60612, USA.
Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology (Impact Factor: 2.6). 10/2008; 101(3):271-8. DOI: 10.1016/S1081-1206(10)60492-9
Source: PubMed


Prevalence of asthma in developed countries increased between the 1970s and the 1990s. One factor that might contribute to the trends in asthma is the increased use of acetaminophen vs aspirin in children and pregnant women.
To examine relationships between in utero exposure to acetaminophen and incidence of respiratory symptoms in the first year of life.
A total of 345 women were recruited in the first trimester of pregnancy and followed up with their children through the first year of life. Use of acetaminophen in pregnancy was determined by questionnaire and related to incidence of respiratory symptoms.
Use of acetaminophen in middle to late but not early pregnancy was significantly related to wheezing (odd ratio, 1.8; 95% confidence interval, 1.1-3.0) and to wheezing that disturbed sleep (odds ratio, 2.1; 95% confidence interval, 1.1-3.8) in the first year of life after control for potential confounders.
This study suggests that use of acetaminophen in middle to late but not early pregnancy may be related to respiratory symptoms in the first year of life. Additional follow-up will examine relationships of maternal and early childhood use of acetaminophen with incidence of asthma at ages 3 to 5 years, when asthma diagnosis is more firmly established.

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    • "The main evidence for association between using of acetaminophen and the risk of childhood asthma develops from the International Study of Asthma and Allergies in Childhood, which included data from 72 centers in 31 countries worldwide (4). This association is constantly present in countries with different patterns of childhood febrile disorders (9-11). Countries with higher sale of Paracetamol or high Paracetamol use had a higher prevalence of asthma and other atopic disease (12). "
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    ABSTRACT: Acetaminophen exposure might be associated with increasing risk of asthma prevalence and other atopic disorders over recent decades. The present study aimed to investigate the association between acetaminophen exposure and the risk of developing childhood asthma. A case - control study was undertaken between March and September 2010 in Urmia district north west of Iran. Subjects were children aged between 2 - 8 years old. Cases were asthmatic children diagnosed based on GINA criteria (n=207) and controls were children without asthma symptoms (n=414) using 1:2 sampling method. Cases and controls were matched for age and gender. Clinical data including Acetaminophen exposure was collected by a questionnaire which completed by interviewing with parents/ guardians. Using Acetaminophen during the first year of life had no any effect on the risk of asthma (p=0.19), but amongst 2-8 years old children, this association was observed (p<0.001). There was also a doseresponseassociation between Acetaminophen consumption and risk of asthma (OR: 3.8; 95% CI; 2.15 6.59 for once per 2 to 3 month and OR: 4.2; 2.50 - 7.3 for at least one per month). Using Acetaminophen increases risk of asthma among 2 - 8 years old children. However stronger evidences are required to design evidence-based guidelines to reduce acetaminophen consumption following post - vaccination and other febrile disorders.
    Full-text · Article · Oct 2012
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    • "In 2010, Feldkamp et al. reported data from the National Birth Defects Prevention Study that showed no increased risks with maternal acetaminophen exposure for each of over 50 birth defects (Feldkamp et al., 2010). Before the pandemic, some studies had shown an association between maternal acetaminophen use and asthma in childhood (Shaheen et al., 2002; Koniman et al., 2007; Persky et al., 2008; Rebordosa et al., 2008; Garcia-Marcos et al., 2009), although not all studies had identified an association (Kang et al., 2009). Two additional studies became available after the pandemic, but these have failed to quell the controversy over this issue. "
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