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Exposure to Paracetamol in Early Pregnancy and the Risk of Developing Cerebral Palsy : A Case-Control Study Using Serum Samples

Thacher, Jesse D LU ; Högfeldt, Hannah ; Vilhelmsson, Andreas LU orcid ; Lindh, Christian LU orcid and Rylander, Lars LU orcid (2024) In Journal of Pediatrics
Abstract

OBJECTIVE: To investigate whether maternal paracetamol use in early pregnancy is associated with cerebral palsy (CP) in offspring.

STUDY DESIGN: We conducted a registry and biobank-based case-control study with mother-child pairs. We identified CP cases (n=322) born between 1995-2014 from a nationwide CP-registry. Randomly selected controls (n=343) and extra preterm controls (n=258) were obtained from a birth registry. For each mother, a single serum sample from early pregnancy (gestation weeks 10-14) was retrieved from a biobank and analyzed for serum concentrations of paracetamol, categorized into unexposed (<1 ng/ml), mildly exposed (1-100 ng/ml), and highly exposed (>100 ng/ml), and in quartiles. Analyses were performed... (More)

OBJECTIVE: To investigate whether maternal paracetamol use in early pregnancy is associated with cerebral palsy (CP) in offspring.

STUDY DESIGN: We conducted a registry and biobank-based case-control study with mother-child pairs. We identified CP cases (n=322) born between 1995-2014 from a nationwide CP-registry. Randomly selected controls (n=343) and extra preterm controls (n=258) were obtained from a birth registry. For each mother, a single serum sample from early pregnancy (gestation weeks 10-14) was retrieved from a biobank and analyzed for serum concentrations of paracetamol, categorized into unexposed (<1 ng/ml), mildly exposed (1-100 ng/ml), and highly exposed (>100 ng/ml), and in quartiles. Analyses were performed using logistic regression and adjusted for potential confounders. Separate analyses were conducted including only those children born preterm and only those born term.

RESULTS: Of the 923 participants, 36.8% were unexposed, 53.2% mildly exposed, and 10% highly exposed to paracetamol. Overall, prenatal exposure to paracetamol was not associated with CP. Sensitivity and subgroup analyses showed no clear associations between paracetamol and CP across strata of term/preterm birth as well as subtypes of CP.

CONCLUSIONS: The present study does not support an association between intrauterine exposure to paracetamol in early pregnancy and the risk of CP. However, it is important to stress that the exposure estimate is based on a single serum sample.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acetaminophen, Biobank, Cerebral palsy, Case-control, Paracetamol
in
Journal of Pediatrics
article number
113959
pages
28 pages
publisher
Academic Press
external identifiers
  • scopus:85186972351
  • pmid:38369234
ISSN
1097-6833
DOI
10.1016/j.jpeds.2024.113959
language
English
LU publication?
yes
additional info
Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.
id
432f22f7-7262-426b-b010-b7a2e48fc8bd
date added to LUP
2024-02-28 10:17:28
date last changed
2024-04-17 12:22:51
@article{432f22f7-7262-426b-b010-b7a2e48fc8bd,
  abstract     = {{<p>OBJECTIVE: To investigate whether maternal paracetamol use in early pregnancy is associated with cerebral palsy (CP) in offspring.</p><p>STUDY DESIGN: We conducted a registry and biobank-based case-control study with mother-child pairs. We identified CP cases (n=322) born between 1995-2014 from a nationwide CP-registry. Randomly selected controls (n=343) and extra preterm controls (n=258) were obtained from a birth registry. For each mother, a single serum sample from early pregnancy (gestation weeks 10-14) was retrieved from a biobank and analyzed for serum concentrations of paracetamol, categorized into unexposed (&lt;1 ng/ml), mildly exposed (1-100 ng/ml), and highly exposed (&gt;100 ng/ml), and in quartiles. Analyses were performed using logistic regression and adjusted for potential confounders. Separate analyses were conducted including only those children born preterm and only those born term.</p><p>RESULTS: Of the 923 participants, 36.8% were unexposed, 53.2% mildly exposed, and 10% highly exposed to paracetamol. Overall, prenatal exposure to paracetamol was not associated with CP. Sensitivity and subgroup analyses showed no clear associations between paracetamol and CP across strata of term/preterm birth as well as subtypes of CP.</p><p>CONCLUSIONS: The present study does not support an association between intrauterine exposure to paracetamol in early pregnancy and the risk of CP. However, it is important to stress that the exposure estimate is based on a single serum sample.</p>}},
  author       = {{Thacher, Jesse D and Högfeldt, Hannah and Vilhelmsson, Andreas and Lindh, Christian and Rylander, Lars}},
  issn         = {{1097-6833}},
  keywords     = {{Acetaminophen; Biobank; Cerebral palsy; Case-control; Paracetamol}},
  language     = {{eng}},
  month        = {{02}},
  publisher    = {{Academic Press}},
  series       = {{Journal of Pediatrics}},
  title        = {{Exposure to Paracetamol in Early Pregnancy and the Risk of Developing Cerebral Palsy : A Case-Control Study Using Serum Samples}},
  url          = {{http://dx.doi.org/10.1016/j.jpeds.2024.113959}},
  doi          = {{10.1016/j.jpeds.2024.113959}},
  year         = {{2024}},
}