Evidence map›Paper›PMID 31637744›Full record

ArticlePaediatric and perinatal epidemiology2020

Associations of prenatal or infant exposure to acetaminophen or ibuprofen with mid-childhood executive function and behaviour.

Sheryl L Rifas-Shiman, Andres Cardenas, Marie-France Hivert, Henning Tiemeier, Andrea D Bertoldi, Emily Oken

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Paediatric and perinatal epidemiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07316387 (Neurobehavioral Development in Toddlers and Preschoolers in Relation to Prenatal Exposure of Mild Analgesics), which is not on this map. Cited by 14 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 3 pooled it
4.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07316387 enrolling by invitationnot on this mapstarted 2024, after this paper: background citation

Neurobehavioral Development in Toddlers and Preschoolers in Relation to Prenatal Exposure of Mild Analgesics

TypeobservationalSponsorRigshospitalet, DenmarkRan2024 to 2028Enrolled685ConditionsGonad Regulating Hormone Adverse Reaction, Analgesic Adverse Reaction, Developmental Disability, Adhd
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Long-Term Safety of Prenatal and Neonatal Exposure to Paracetamol: A Systematic Review.International journal of environmental research and public health · 2022
    Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 3 countries.

Sheryl L Rifas-ShimanDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.ORCID 0000-0003-0033-920X
Andres CardenasDivision of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA.
Marie-France HivertDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Henning TiemeierDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Andrea D BertoldiPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.ORCID 0000-0002-4680-3197
Emily OkenDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Harvard University · USBerkeley Public Health Division · USUniversidade Federal de Pelotas · BR

Funding

Prenatal environmental determinants of health in young adulthood: a lifecourse approachR01HD034568 · NICHD · HARVARD PILGRIM HEALTH CARE, INC. · PI Marie-France Hivert, Emily Oken · 1998 to 2026
$20.6M
Common and distinct early environmental influences on cardiometabolic and respiratory health: Mechanisms and methodsUH3OD023286 · OD · HARVARD PILGRIM HEALTH CARE, INC. · PI OKEN, EMILY · 2018 to 2022
$11.7M
The Fetal and Childhood Environment, Oxidative Balance, Inflammation and AsthmaR01AI102960 · NIAID · BRIGHAM AND WOMEN'S HOSPITAL · PI GOLD, DIANE R, OKEN, EMILY · 2013 to 2017
$4.0M
Medical Research Council G9815508Medical Research Council MC_PC_19009NIAID NIH HHS R01 AI102960NICHD NIH HHS R01 HD034568NIH HHS UH3 OD023286
6 · The paper itself

Abstract

backgroundOver-the-counter analgesics during pregnancy or infancy may be related to neurobehavioural problems in children, but little is known about effects of different analgesic types, dosage, and timing.

objectivesExamine associations of acetaminophen and ibuprofen use during pregnancy and infancy with executive function and behaviour problems in children.

methodsWe included 1225 mother-child pairs from Project Viva, a pre-birth cohort study. We assessed prenatal acetaminophen and ibuprofen use in early and mid-pregnancy and infant use in the first year of life using questionnaires. Parents and classroom teachers assessed child behaviours in mid-childhood (median 8 years), using the Behavior Rating Inventory of Executive Function (BRIEF) and the Strengths and Difficulties Questionnaire (SDQ), with higher scores indicating worse functioning for both. We examined associations of acetaminophen and ibuprofen use during pregnancy and infancy with mid-childhood neurobehavioural outcomes using linear regression models adjusted for potential confounders.

resultsDuring pregnancy, 46.1% of mothers used acetaminophen ≥10 times and 18.4% used any ibuprofen. In the first year, 65.3% and 39.6% of infants received acetaminophen and ibuprofen ≥6 times, respectively. Higher (≥10 vs <10 times) prenatal acetaminophen (β 1.64 points; 95% confidence interval [CI] 0.59, 2.68) and any ibuprofen (β 1.56, 95% CI 0.19, 2.92) were associated with higher parent-rated BRIEF global scores. Patterns of association were linear across categories and were similar for other parent- and teacher-rated outcomes. Infancy exposure (≥6 vs <6 times) to acetaminophen (β 1.69, 95% CI 0.51, 2.87) and ibuprofen (β 1.40, 95% CI 0.25, 2.55) were associated with higher parent-rated BRIEF GEC scores but associations with teacher-rated scores were weaker.

conclusionsPrenatal and early-life exposure to acetaminophen and ibuprofen were associated with poorer executive function and behaviour in childhood. These findings highlight the need for further research on the mechanisms through which analgesics may act on fetal and child brain development.

Indexed as

AcetaminophenChild Behavior DisordersIbuprofenPregnancy ComplicationsPrenatal Exposure Delayed EffectsAge FactorsAnalgesics, Non-NarcoticChildChild BehaviorChild, PreschoolCognitionCohort StudiesExecutive FunctionFemaleGestational AgeHumansAcetaminophenAnalgesics, Non-NarcoticIbuprofenacetaminophenchild behaviourchild executive functionibuprofeninfancypregnancy

Identifiers

PMID31637744
PMCPMC7170759
OpenAlexW2982180432

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.