ArticleAmerican journal of epidemiology2026
Prenatal over-the-counter acetaminophen use and birth outcomes in the ECHO Cohort.
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Article in American journal of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
36 authors.
Katelyn K HuffDepartment of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States.ORCID 0000-0001-8566-599X
Noya GalaiDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.ORCID 0000-0001-8280-9492
Garrett FuselierDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Guojing WuDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Hadley J HartwellDepartment of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States.ORCID 0000-0003-4453-3266
Catherine M BulkaDepartment of Epidemiology, College of Public Health, University of South Florida, Tampa, FL, United States.ORCID 0000-0002-6529-7226
Margaret A AdgentDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, TN, United States.ORCID 0000-0002-5951-5514
Akram N AlshawabkehDepartment of Civil and Environmental Engineering, College of Engineering, Northeastern University, Boston, MA, United States.ORCID 0000-0001-5243-4087
Brennan H BakerDepartment of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States.ORCID 0000-0001-5459-9141
Maria M Talavera-BarberAvera Research Institute, Avera McKennan Hospital & University Health Center, Sioux Falls, SD, United States.ORCID 0000-0002-5290-1375
Traci A BekelmanLifecourse Epidemiology of Adiposity & Diabetes Center, Colorado School of Public Health, Aurora, CO, United States.ORCID 0000-0003-0840-1186
Whitney CowellDepartments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, United States.ORCID 0000-0002-1824-3356
Zoe T DubersteinDepartment of Psychology, University of Rochester, Rochester, NY, United States.ORCID 0000-0002-6522-756X
Amy J ElliottAvera Research Institute, Avera McKennan Hospital & University Health Center, Sioux Falls, SD, United States.ORCID 0000-0003-0608-8931
Daniel A EnquobahrieDepartment of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States.ORCID 0000-0001-9844-0597
Akhgar GhassabianDepartments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, United States.ORCID 0000-0001-9551-4706
Margaret R KaragasDepartment of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, United States.ORCID 0000-0002-6398-7362
Amber KautzDepartment of Public Health Sciences, Division of Epidemiology, University of Rochester, Rochester, NY, United States.ORCID 0000-0001-8463-9167
Barry M LesterBrown Center for the Study of Children at Risk, Alpert Medical School of Brown University, Women and Infants Hospital, Providence, RI, United States.ORCID 0000-0003-0267-9814
Tengfei MaDepartment of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States.
Cindy T McEvoyDepartment of Pediatrics, Oregon Health and Science University, Portland, OR, United States.ORCID 0000-0001-8501-8813
Kimberly S McKeeDepartment of Family Medicine, University of Michigan, Ann Arbor, MI, United States.ORCID 0000-0002-2905-5000
John D MeekerDepartment of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.ORCID 0000-0001-8357-5085
Ruby H N NguyenDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.ORCID 0000-0002-6598-8457
Thomas G O'ConnorDepartment of Psychology, University of Rochester, Rochester, NY, United States.
Nigel PanethDepartment of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States.ORCID 0000-0002-0151-966X
Wei PerngLifecourse Epidemiology of Adiposity & Diabetes Center, Colorado School of Public Health, Aurora, CO, United States.ORCID 0000-0001-8552-6850
Christina A PorucznikDivision of Public Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT, United States.ORCID 0000-0003-1973-2917
Sheela SathyanarayanaDepartment of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States.ORCID 0000-0002-1480-0397
Hyagriv N SimhanDepartment of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
Shanna H SwanDepartment of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States.ORCID 0000-0001-9564-0614
Megan L WoodburyDepartment of Civil and Environmental Engineering, College of Engineering, Northeastern University, Boston, MA, United States.ORCID 0000-0003-1444-2603
Stephan EhrhardtDepartment of Statistics, University of Haifa, Mt Carmel, Israel.ORCID 0009-0005-5820-3956
T Michael O'SheaDepartment of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, United States.ORCID 0000-0001-6692-911X
Rebecca C FryDepartment of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States.ORCID 0000-0003-0899-9018
For The Echo Cohort Consortium
Funding
Project-005U2COD023375 · OD · DUKE UNIVERSITY · PI Linda S Adair, Phillip Brian Smith · 2016 to 2026
$215.9MECHODAC (Environmental Influences on Child Health Outcomes Data Analysis Center)U24OD023382 · OD · JOHNS HOPKINS UNIVERSITY · PI Diane J Catellier, LISA P JACOBSON · 2016 to 2026
$148.4MThe ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child HealthU24OD023319 · OD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Courtney K Blackwell, RICHARD GERSHON · 2016 to 2026
$43.7MPrenatal and Early Childhood Pathways To Health: An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUH3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2018 to 2022
$37.3MECHO Laboratory Core at Vanderbilt for Integrated Sample Biobanking and ProcessingU24OD035523 · OD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Suman Ranjan Das, NATASHA Bassam HALASA · 2023 to 2026
$32.8MLifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory Health (LA DREAMERs)UH3OD023287 · OD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BASTAIN, THERESA M, BRETON, CARRIE VAN DOREN · 2018 to 2022
$28.4MStatistical Services and Methods Development ResourceU2CES026555 · NIEHS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI GENNINGS, CHRIS · 2015 to 2025
$26.4MUntargeted Analysis ResourceU2CES026561 · NIEHS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI WRIGHT, ROBERT O · 2015 to 2025
$24.5MEarly Life Stress and the Environmental Origins of Disease: a Population-based Prospective Longitudinal Study of Children in Rural Poverty (ECHO)UH3OD023332 · OD · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI KOPP, LISA MICHELLE, SWINGLER, MARGARET M. · 2018 to 2022
$22.7MENVIRONMENTAL INFLUENCES ON NEURODEVELOPMENTAL OUTCOME IN INFANTS BORN VERY PRETERMUH3OD023347 · OD · WOMEN AND INFANTS HOSPITAL-RHODE ISLAND · PI LESTER, BARRY M., MARSIT, CARMEN JOSEPH · 2018 to 2022
$18.4MBREAKING THE CYCLE OF INTERGENERATIONAL DISADVANTAGE: NEURODEVELOPMENT AMONG PUERTO RICAN CHILDREN.UH3OD023328 · OD · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI CANINO, GLORISA J, DUARTE, CRISTIANE S. · 2018 to 2022
$18.3MWadsworth Center's Human Health and Exposure Analysis Resource (WC-HHEAR)U2CES026542 · NIEHS · WADSWORTH CENTER · PI KANNAN, KURUNTHACHALAM, KANNAN, KURUNTHACHALAM · 2015 to 2025
$15.6MNIEHS NIH HHS U24 ES026539NIEHS NIH HHS U2C ES026533NIEHS NIH HHS U2C ES026542NIEHS NIH HHS U2C ES026555NIEHS NIH HHS U2C ES026561NIEHS NIH HHS U2C ES030851NIEHS NIH HHS U2C ES030857NIEHS NIH HHS U2C ES030859NIH HHS U24 OD023319NIH HHS U24 OD023382NIH HHS U24 OD035523NIH HHS U2C OD023375NIH HHS UG3 OD035508NIH HHS UG3 OD035509NIH HHS UG3 OD035513NIH HHS UG3 OD035516NIH HHS UG3 OD035517NIH HHS UG3 OD035518NIH HHS UG3 OD035519NIH HHS UG3 OD035521NIH HHS UG3 OD035526NIH HHS UG3 OD035527NIH HHS UG3 OD035528NIH HHS UG3 OD035529NIH HHS UG3 OD035532NIH HHS UG3 OD035533NIH HHS UG3 OD035536NIH HHS UG3 OD035537NIH HHS UG3 OD035540NIH HHS UG3 OD035542NIH HHS UG3 OD035543NIH HHS UG3 OD035544NIH HHS UG3 OD035546NIH HHS UG3 OD035550NIH HHS UH3 OD023268NIH HHS UH3 OD023271NIH HHS UH3 OD023286NIH HHS UH3 OD023287NIH HHS UH3 OD023318NIH HHS UH3 OD023320NIH HHS UH3 OD023328NIH HHS UH3 OD023332NIH HHS UH3 OD023347the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health ES0266542the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health U24ES026539the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health U24OD023319the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health U24OD023382the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health U24OD035523the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health U2CES026533the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health U2CES026542the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health U2CES026555the 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Abstract
Acetaminophen is among the most common over-the-counter medications used during pregnancy. Given inconsistent findings from both experimental and epidemiological studies on associations between use and adverse health outcomes, further research is warranted. To address this, our objective was to assess the relationship between prenatal acetaminophen use and birth outcomes. We studied 8957 mother-infant pairs from 36 pediatric study sites participating in the Environmental influences on Child Health Outcomes (ECHO) program. After imputation and inverse probability weighting, we used regression models to examine the relationship between acetaminophen during pregnancy and the following outcomes: (1) preterm birth, (2) birthweight, (3) small-for-gestational age (SGA), and (4) large-for-gestational-age (LGA). Approximately 59% of mothers reported using acetaminophen at any point during their pregnancy (n = 5257). After adjustment for relevant covariates, prenatal acetaminophen use was associated with lower odds of LGA (adjusted odds ratio [aOR]: 0.87; 95% CI: 0.79, 0.96). Prenatal acetaminophen use was not associated with preterm birth (aOR: 0.99; 95% CI: 0.86, 1.14), birthweight (aβ: -7.52 g; 95% CI: -27.80, 12.77) or SGA (aOR: 1.02; 95% CI: 0.88, 1.18). Based on these findings, future research should test for dose-response, trimester-specific exposures, and factors affecting individual responses.
Indexed as
AcetaminophenAnalgesics, Non-NarcoticNonprescription DrugsPregnancy OutcomePremature BirthAdultBirth WeightCohort StudiesFemaleHumansInfant, Large for Gestational AgeInfant, NewbornInfant, Small for Gestational AgePregnancyUnited StatesYoung AdultAcetaminophenAnalgesics, Non-NarcoticNonprescription Drugsacetaminophenbirthweightlarge-for-gestational-agepreterm birthsmall-for-gestational-age
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