TY - JOUR

T1 - Behavioral Problems at Age 11 Years After Prenatal and Postnatal Exposure To Acetaminophen

T2 - Parent-reported and Self-reported Outcomes

AU - Inoue, Kosuke

AU - Ritz, Beate

AU - Ernst, Andreas

AU - Tseng, Wan-Ling

AU - Yuan, Yuying

AU - Meng, Qi

AU - Ramlau-Hansen, Cecilia Høst

AU - Strandberg-Larsen, Katrine

AU - Arah, Onyebuchi A

AU - Obel, Carsten

AU - Li, Jiong

AU - Olsen, Jørn

AU - Liew, Zeyan

N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2021

Y1 - 2021

N2 - Several studies have reported associations between prenatal acetaminophen exposure and behavioral outcomes in young children. We aimed to evaluate the associations of prenatal and postnatal exposures to acetaminophen with behavioral problems in children at age 11 years, using behavioral measures reported by parents and children. We studied 40,934 mother-child pairs from the Danish National Birth Cohort enrolled during 1996-2002. Parent-reported and child-reported Strengths and Difficulties Questionnaires (SDQ) were collected during the 11-year follow-up. We estimated risk ratios for behavioral problems including total difficulties, and internalizing or externalizing behaviors following prenatal (during pregnancy) or postnatal (within the first 18 months after birth) acetaminophen exposure. Parent-reported and child-reported SDQ scores were moderately correlated; higher for externalizing (r=0.59) than internalizing behaviors (r=0.49). Prenatal acetaminophen exposure was associated with 10-40% higher risks for total difficulties and internalizing and externalizing problems based on parent- or child-reported SDQ with the association being stronger for greater cumulative weeks of acetaminophen use. Postnatal exposure was associated with 16-19% higher risks for parent-reported internalizing behaviors, but the associations were weak or null for child-reported scores except for prosocial behavior. Our study corroborates published associations between prenatal exposures to acetaminophen and behavioral problems and extends the literature to early adolescence.

AB - Several studies have reported associations between prenatal acetaminophen exposure and behavioral outcomes in young children. We aimed to evaluate the associations of prenatal and postnatal exposures to acetaminophen with behavioral problems in children at age 11 years, using behavioral measures reported by parents and children. We studied 40,934 mother-child pairs from the Danish National Birth Cohort enrolled during 1996-2002. Parent-reported and child-reported Strengths and Difficulties Questionnaires (SDQ) were collected during the 11-year follow-up. We estimated risk ratios for behavioral problems including total difficulties, and internalizing or externalizing behaviors following prenatal (during pregnancy) or postnatal (within the first 18 months after birth) acetaminophen exposure. Parent-reported and child-reported SDQ scores were moderately correlated; higher for externalizing (r=0.59) than internalizing behaviors (r=0.49). Prenatal acetaminophen exposure was associated with 10-40% higher risks for total difficulties and internalizing and externalizing problems based on parent- or child-reported SDQ with the association being stronger for greater cumulative weeks of acetaminophen use. Postnatal exposure was associated with 16-19% higher risks for parent-reported internalizing behaviors, but the associations were weak or null for child-reported scores except for prosocial behavior. Our study corroborates published associations between prenatal exposures to acetaminophen and behavioral problems and extends the literature to early adolescence.

U2 - 10.1093/aje/kwaa257

DO - 10.1093/aje/kwaa257

M3 - Journal article

C2 - 33230558

VL - 190

SP - 1009

EP - 1020

JO - American Journal of Epidemiology

JF - American Journal of Epidemiology

SN - 0002-9262

IS - 6

ER -