Prenatal and postnatal exposure to acetaminophen in relation to autism spectrum and attention-deficit and hyperactivity symptoms in childhood: Meta-analysis in six European population-based cohorts
link.springer.com
The potential etiological role of early acetaminophen exposure on Autism Spectrum Conditions (ASC) and Attention-Deficit/Hyperactivity Disorder (ADHD) is inconclusive. We aimed to study this association in a collaborative study of six European population-based birth/child cohorts. A total of 73,881 mother–child pairs were included in the study. Prenatal and postnatal (up to 18 months) acetaminophen exposure was assessed through maternal questionnaires or interviews. ASC and ADHD symptoms were assessed at 4–12 years of age using validated instruments. Children were classified as having borderline/clinical symptoms using recommended cutoffs for each instrument. Hospital diagnoses were also available in one cohort. Analyses were adjusted for child and maternal characteristics along with indications for acetaminophen use. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. The proportion of children having borderline/clinical symptoms ranged between 0.9 and 12.9% for ASC and between 1.2 and 12.2% for ADHD. Results indicated that children prenatally exposed to acetaminophen were 19% and 21% more likely to subsequently have borderline or clinical ASC (OR = 1.19, 95% CI 1.07–1.33) and ADHD symptoms (OR = 1.21, 95% CI 1.07–1.36) compared to non-exposed children. Boys and girls showed higher odds for ASC and ADHD symptoms after prenatal exposure, though these associations were slightly stronger among boys. Postnatal exposure to acetaminophen was not associated with ASC or ADHD symptoms. These results replicate previous work and support providing clear information to pregnant women and their partners about potential long-term risks of acetaminophen use.

From the Discussion section:

The results of our meta-analysis representing more than 70,000 children of six European population-based birth/child cohorts indicated that children prenatally exposed to acetaminophen were 19% and 21% more likely to subsequently have ASC and ADHD symptoms within the borderline/clinical range, respectively, compared with non-exposed children. The association with ASC was attenuated after omitting the largest cohort but remained positive. When stratifying by sex, these associations were slightly stronger among boys compared to girls but positive associations with effect sizes of similar magnitude were observed in both strata, especially in the case of ADHD. Postnatal exposure to acetaminophen was not associated with either of the outcome, thought there was evidence of between-study heterogeneity for the association with ASC symptoms.

From the Outcomes section:

ASC and ADHD symptoms were assessed using validated parent-reported questionnaires or linked hospital records. Autistic symptoms were assessed using the Development And Well-Being Assessment (DAWBA) [18] (ALSPAC), the Pervasive Developmental Problems (PDP) subscale of the Child Behaviour Checklist for Toddlers (CBCL1½–5) [19] (GASPII and The Generation R Study), the Childhood Autism Spectrum Test (CAST) [20] (INMA) and an ASC scale derived from the CBCL for 6–18 (CBCL6–18) [21] (RHEA). ADHD symptoms were assessed using the Development and Well-Being Assessment (DAWBA) [18] (ALSPAC); the Conner’s Parent Rating Scale Revised short form (CPRS-R:S) [22] (The Generation R Study), the Hyperactivity/Inattention subscale of the Strengths and Difficulties Questionnaire (SDQ) [23] (DNBC), the Attention Deficit and Hyperactivity problems subscale of the CBCL1½-5 and CBCL6/18 (GASPII and RHEA), and the ADHD Criteria of DSM-IV (DSM-ADHD Questionnaire) [24] (INMA). Higher scores indicate more symptoms.

  • RNAi [he/him]
    ·
    4 years ago

    Are we at it again? Pulling a Wakefield?

    • Civility [none/use name]
      ·
      4 years ago

      The first author seems pretty legit: https://scholar.google.es/citations?user=fyIpcC8AAAAJ

      • BeamBrain [he/him]
        ·
        4 years ago

        Wakefield was the crank who started the "vaccines cause autism" claim.

        • Chomsky [comrade/them]
          ·
          4 years ago

          All he did was say that there is a bunch of anecdotal evidence for a relationship and that it might be a good idea to do a study to determine if there is a link. He became salty about it and went on a crusade after he career was totally decimated. He was just a fall guy for what has been an all around public relations disaster in regards to vaccinations and public health that goes way beyond what one person could have accomplished. "Blame some crank" seems a lot better in the short therm than "What are the material conditions that have led to 40-60% of the population having zero confidence in science or really any public institutions."

            • Mardoniush [she/her]
              ·
              4 years ago

              It's even worse than that. The Vaaccine grift was a side gig, he was paid by a law firm to falsify a study for them.

              Some of the kids were claimed to be autistic but were the neurotypical siblings of another subject and were just added in. Its a shockingly unethical study

          • iwishthiswasicq [none/use name]
            ·
            4 years ago

            He is far far worse lol, dude is actually a pos who put autistic children through needless invasive and painful surgeries to try to find something that he knew didn't exist due to previous testing to help a lawyer make millions suing pharmaceutical companies. It was literally all a ploy to make money.

            • Chomsky [comrade/them]
              ·
              4 years ago

              OK, so throw him in jail. I am sure there is a lawsuit or something against him since everyone hates his guts. My point isn't to downplay whatever he did, I am not super well versed on what he did. My point is that his relevance to the anti-vaxxer movement is wildly exaggerated. If your scientific community can't counter one quack scientist you have a major problem.

                • Chomsky [comrade/them]
                  ·
                  4 years ago

                  I explained it in other posts in this thread. Long tradition of corporate anti science combined with profit motive at the heart of the health care system (which, if wakefield was paid to falsify studies, is a pretty good case in point). base--->superstructure.

                  It is like policing, this is not a bad apple issue, this is a systemic issue that arises from material conditions of capitalism.

                • Nakoichi [they/them]
                  ·
                  4 years ago

                  It existed before him, he was just another grifter and tying it to him is some great man theory shit. I know this because I grew up around a bunch of anti-vaxx weirdos prior to him.

              • RNAi [he/him]
                ·
                4 years ago

                The people in charge of preventing this shitstorm were the editors and reviewers of The Lancet, who failed tremendously.

                • Chomsky [comrade/them]
                  ·
                  4 years ago

                  There are definitely major issues with the scientific community in general. Rampant careerism for one.

          • RNAi [he/him]
            ·
            4 years ago

            I always thought he was a sloppy scientist nobody gave a shit at the moment nor even himself. But turns out:

            • He was paid half million pounds by a lawyer to craft a publication linking the MMR vaccine to autism to then sue the UK government.
            • It was planned as a PR campaign from the beginning .
            • The science wasn't "sloppy", it was deliberately bad, awful, horrible, and kids were tortured in the process
            • He knew MMR vaccination was gonna drop, and after the first deaths from measles he didn't retracted and spilled the beans in shame.
          • Nephron [he/him]
            ·
            4 years ago

            That's a very charitable view of Wakefield lol

            • Chomsky [comrade/them]
              ·
              4 years ago

              I don't give a rats ass about Wakefield. The point is that the idea that some guy claiming that there is some anecdotal evidence that a vaccine might have a side effect set off a catastrophic public health crisis is nonsense. If you have normal levels of public trust in institutions then he makes that claim it's in the news for two weeks, the entire scientific community counters that claim and everyone moves on. Anti vaxxers are the result of decades of the profit motive being at the heart of public health in tandem with decades of corporate funded anti science from the cigarette industry, to the sugar industry, the oil industry and so on. This has nothing to do with a bad apple and is not some superstructural problem, it is a problem that stems directly from the economic base. The Wakefield obsession is the result of liberals not being able to address the actual problem because the problem is liberalism.

              • CptKrkIsClmbngThMntn [any]
                ·
                4 years ago

                Good to see sense here. The hate for Wakefield is forever justified but putting the blame all on him instead of analyzing the material barriers to vaccine acceptance is a major reddit moment.

  • cawsby [he/him]
    ·
    4 years ago

    Neat.

    I have ADHD and tylenol does fuck all for me for pain.

  • sunneonix [none/use name]
    ·
    4 years ago

    man, between this and Reye's Syndrome, Ibuprofen looking more redpilled by the day.

  • Parent [none/use name]
    ·
    4 years ago

    What if the people that take acetaminophen have some underlying issue that actually causes the ASC and they just happen to take acetaminophen for it?

    • Chomsky [comrade/them]
      ·
      4 years ago

      I would certainly hope that they would try to control for that in the study.

          • sysgen [none/use name,they/them]
            ·
            4 years ago

            Sex, history of infection, parental age and education.

            These aren't very big risk factors for ADHD (though age is a big one for autism), mainly it's that we simply don't know of a lot of covariates for ASD and ADHD for now.

            • Chomsky [comrade/them]
              ·
              4 years ago

              Yeah, just saying that they try and do say that the controls were limited. I mean, we won't find the risk factors if we don't look.

              Like, if the study is funded by asparin manufacturers yeah it's problematic, but I don't see anything wrong at first glance.

              • sysgen [none/use name,they/them]
                ·
                4 years ago

                Sure, I'm just saying that OP's hypothesis that there is a third common factor is definitely possible, correlation isn't causation, etc...

                But yes, a solid mechanism and further studied are needed. Otherwise there isn't anything obviously wrong, but it's not sufficient for a causative link yet. There is probably something to it.

                For all we know they might have asked for thirty common medications and done p-hacking, or a dozen other things, which is why we can't jump to conclusions yet.

                Meanwhile you should take ibuprofen just in case lol

                • Chomsky [comrade/them]
                  ·
                  4 years ago

                  Yeah. I have a friend that is a statistician and she does medical research. She does data mining, basically just throws numbers at the wall and sees what sticks and passes off correlations to other researchers for possible further study.

                  Definitely a bit of a yikes for me because my son just finished teething and we use acetaminophen on days it was bad.

  • dapranker [he/him]
    ·
    4 years ago

    Now I'm paranoid because my pregnant wife took tylenol today

    What dosage are we talking about here? Study seems to be "any" exposure which seems like it needs a lot of followup

    • FidelCashflow [he/him]
      ·
      4 years ago

      Congratulations on your future computer programer.

      Probably a super low increased risk and those conditions are mostly genetic. As far as we know currently anyway

  • FidelCashflow [he/him]
    ·
    4 years ago

    This is intresting especially given that people say high fevers reduce autisim synptoms and Tylenol lowers fever. I expect this won't come out to mich but it is intresting