Article

Acetaminophen Use in Pregnancy and Risk of Birth Defects Findings From the National Birth Defects Prevention Study

Division of Medical Genetics, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
Obstetrics and Gynecology (Impact Factor: 5.18). 01/2010; 115(1):109-15. DOI: 10.1097/AOG.0b013e3181c52616
Source: PubMed

ABSTRACT

To investigate whether exposure during the first trimester of pregnancy to single-ingredient acetaminophen increases the risk of major birth defects.
Data from the National Birth Defects Prevention Study, a population-based, case-control study, were used. Women who delivered between January 1, 1997, and December 31, 2004, and participated in the telephone interview were included. Type and timing of acetaminophen use were assigned based on maternal report. Women reporting first-trimester acetaminophen use in a combination product were excluded, resulting in a total of 11,610 children in the case group and 4,500 children in the control group for analysis.
The prevalence of first-trimester single-ingredient-acetaminophen use was common: 46.9% (n=5,440) among women in the case group and 45.8% (n=2,059) among women in the control group (P=.21). Overall, acetaminophen was not associated with an increased risk of any birth defect. Among women reporting a first-trimester infection and fever, use of acetaminophen was associated with a statistically significantly decreased odds ratio (OR) for anencephaly or craniorachischisis (adjusted OR 0.35, 95% confidence interval [CI] 0.08-0.80), encephalocele (adjusted OR 0.17, 95% CI 0.03-0.87), anotia or microtia (adjusted OR 0.25, 95% CI 0.07-0.86), cleft lip with or without cleft palate (adjusted OR 0.44, 95% CI 0.26-0.75), and gastroschisis (adjusted OR 0.41, 95% CI 0.18-0.94).
Single-ingredient-acetaminophen use during the first trimester does not appear to increase the risk of major birth defects. It may decrease the risk of selected malformations when used for a febrile illness.
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    • "Other studies have reported associations between peri-conceptual use of codeine and the incidence of neural tube defects[18]and neuroblastoma[19]. Co-administration of codeine with paracetamol is unlikely to explain the higher rate of congenital abnormalities , because paracetamol per se is not associated with an increase in birth abnormalities[20,21]. The worrying associations between use of codeine and birth defects are, however, tempered by a recent Norwegian cohort study that failed to identify an association between use of codeine in pregnancy and an increased rate of congenital malfor- mations[22]. "

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    • "This literature search yielded 33 studies with medication usage rates for 14 out of 17 countries with autism prevalence rates. Two studies were excluded because they were subsets of two included studies to yield a total of 31 studies [44,45]. If multiple studies were identified for a country a summary usage rate was calculated using the weighted average by study population size. "
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