Prenatal Acetaminophen Exposure and Language Delay in Girls

Ricki Lewis, PhD

January 10, 2018

Prenatal acetaminophen exposure was associated with language delays (LDs) in girls at age 30 months, according to findings published online January 10 in European Psychiatry.

The Centers for Disease Control and Prevention estimates that 65% of pregnant women in the United States use acetaminophen, typically to lower fever and/or relieve pain. Studies have associated lower IQ; behavioral, attentional, and social deficits; and communication difficulties in children whose mothers reported using more acetaminophen during pregnancy, but none have examined a marker of cognitive development such as LD.

Carl-Gustaf Bornehag, PhD, from Karlstad University in Sweden and the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined the possible association between LD in children and acetaminophen use during pregnancy. The prospective cohort study evaluated 754 women participating in the Swedish Environmental Longitudinal, Mother and Child, Asthma and Allergy study. Women enrolled during weeks 8 through 13 of pregnancy.

The researchers ascertained the number of tablets taken from conception through enrollment and measured urinary concentration of the drug at enrollment. A parental questionnaire and nurse evaluation assessed language development of the children at age 30 months, which included the number of words the child used (<25, 25 - 50, and >50). LD, the main study outcome, was parental report of use of fewer than 50 words.

Of the women surveyed, 59.2% reported taking acetaminophen during weeks 8 to 13, and urine concentrations correlated with the reported number of tablets (P < .01), and 8.5% of the children overall in the study exhibited LD.

Although 12.6% of boys had LD compared with 4.1% of girls, acetaminophen dosage and urinary concentration were associated with greater LD in girls, but not in boys. The adjusted odds ratio for LD among girls whose mothers took more than six compared with no tablets during the study period was 5.92 (95% confidence interval, 1.10 - 31.94). The odds ratio for LD in girls reached 10.34 (95% confidence interval, 1.37 - 77.86) for the quartile of mothers with the highest urinary acetaminophen levels compared with the quartile with the lowest levels.

"Given the prevalence of prenatal acetaminophen use and the predictive value of LD, these findings, if replicated, would suggest that pregnant women take the precautionary action of limiting their use of this common analgesic," the researchers conclude. The Swedish Environmental Longitudinal, Mother and Child, Asthma and Allergy study will follow the children and reexamine LD when they are 7 years old.

A limitation of the study was reliance on parental reporting of the number of acetaminophen tablets taken.

The researchers have disclosed no relevant financial relationships.

Euro Psych. Published online January 10, 2018. Abstract

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