Postnatal Acetaminophen and Potential Risk of Autism Spectrum Disorder among Males

Abstract

Some evidence from the literature suggests that postnatal acetaminophen exposure may be associated with increased risk of autism spectrum disorder (ASD). Using a data set obtained from a previous study that was derived from an Internet-based survey among parents on 1515 children from the US, an adjusted odds ratio (aOR) and gender-specific aORs for doses of postnatal acetaminophen provided before age two were calculated against the outcome of ASD. Separately, parental uncertainty on the number of doses of acetaminophen provided was analyzed. A population attributable fraction (PAF) associated with postnatal acetaminophen exposure before age two for ASD among males was also estimated. Postnatal acetaminophen exposure, measured in doses before age two, was found to be associated with ASD among male children (aOR 1.023, CI 1.005–1.043, p = 0.020*), and parental uncertainty on the number of doses of acetaminophen provided before age two was also found to be associated with ASD. Using this data set, the PAF associated with postnatal acetaminophen was estimated to be about 40% of the risk of ASD among male children in the US. These results suggest the possibility that postnatal acetaminophen may be a significant contributor to the risk of ASD among males in the US.

Endocannabinoid System Dysregulation from Acetaminophen Use May Lead to Autism Spectrum Disorder: Could Cannabinoid Treatment Be Efficacious?

“…Interestingly, very recently, it has been demonstrated that post-natal use of acetaminophen before the age of two is associated with an increase in the risk of ASD in male children [ 28 ], further confirming our previous results.…”

Paracetamol (Acetaminophen) and the Developing Brain

“…Paracetamol has been furthermore advocated for the pharmacological closure of a patent ductus arteriosus in very preterm infants, although its efficacy is not superior to oral ibuprofen [2,3]. Follow-up examinations of preterm infants at 2 and 5 years of age currently do not point to altered neurodevelopmental outcome following postnatal paracetamol administration [71][72][73], while analysis of data from a survey among parents on 1515 US children found an increased risk of ASD following postnatal paracetamol administration before age two in boys but not in girls [74]. As a matter of concern, none of the trials employing paracetamol for closure of a patent ductus arteriosus in preterm infants registered with www.clinicialtrials.gov list ADHD and ASD as secondary outcome.…”

Prophylactic low‐dose paracetamol for ductal closure and neurodevelopmental outcome in very preterm infants

“…However, information on long‐term outcome of large cohorts of preterm infants exposed to paracetamol with the attempt to endorse early closure of the ductus arteriosus is lacking. Unfortunately, this is a matter of urgency since there are several reports linking paracetamol exposure during pregnancy or in the neonatal period with adverse outcomes including autism spectrum disorder, attention deficit hyperactivity disorder, lower IQ and language delay 10–20 …”