M Baptiste, B Rennie, K Mitchell

O-36 Prenatal and Early-Life Acetaminophen Exposure: A Systematic Review of Neurodevelopmental Impacts

Author(s): M Baptiste, B Rennie, K Mitchell
Type Of Study:
  • Evidence Synthesis
Year of Presentation: 2025

Abstract

Objective: This systematic review examines the association between acetaminophen exposure during prenatal and early childhood stages and adverse neurodevelopmental outcomes, including autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), and cognitive delays. The findings emphasize implications for public health in the Caribbean.

Methods: A systematic search of PubMed (2000–2024) identified randomized controlled trials, cohort studies, and case-control studies assessing neurodevelopmental outcomes in children exposed to acetaminophen. Studies meeting inclusion criteria underwent quality appraisal and narrative synthesis due to heterogeneity.

Results: Prenatal acetaminophen exposure was consistently linked to increased risks of ASD (odds ratio [OR] 1.26–1.37) and ADHD (OR = 1.21, 95% CI 1.07-1.36). Postnatal exposure was associated with attention-related behavioral problems and mixed evidence on motor development, including higher neurodevelopmental scores in some cohorts (β 0.08, 95% CI 0.01–0.16). Dose-response effects and environmental interactions, such as co-exposure to cannabinoid receptor agonists, were observed in some studies.

Conclusion: Evidence supports significant neurodevelopmental risks associated with acetaminophen exposure. In the Caribbean, where acetaminophen is widely used and easily accessible over the counter, these findings highlight the need for public health campaigns, stricter pregnancy guidelines, and further region-specific research to refine dose thresholds and minimize risks.

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