Paracetamol exposure in pregnancy and early childhood and development of childhood asthma: a systematic review and meta-analysis

@article{Cheelo2014ParacetamolEI,
  title={Paracetamol exposure in pregnancy and early childhood and development of childhood asthma: a systematic review and meta-analysis},
  author={Meetwell Cheelo and Caroline J. Lodge and S. Dharmage and Julie Anne Simpson and Melanie C Matheson and Joachim Heinrich and Adrian J. Lowe},
  journal={Archives of Disease in Childhood},
  year={2014},
  volume={100},
  pages={81 - 89}
}
Background and objective While paracetamol exposure in pregnancy and early infancy has been associated with asthma, it remains unclear whether this is confounded by respiratory tract infections, which have been suggested as an alternative explanation. We undertook a systematic review and meta-analysis of longitudinal studies that reported the association between paracetamol exposure during pregnancy or infancy and the subsequent development of childhood asthma (≥5 years). Methods Two… 
Prenatal Paracetamol Exposure and Wheezing in Childhood: Causation or Confounding?
TLDR
The association between maternal paracetamol use during pregnancy and infant wheezing is mainly, if not completely explained by confounding, explainable by confounding.
The association between paracetamol and asthma is still under debate
TLDR
There are many arguments that suggest a relationship between the use of paracetamol with the appearance of asthmatic symptoms, however the evidence is inconclusive.
Intrauterine Exposure to Acetaminophen and Adverse Developmental Outcomes: Epidemiological Findings and Methodological Issues.
TLDR
Given the high prevalence of use, findings regarding intrauterine exposure to acetaminophen on multiple child health outcomes raise concerns and research on causal and non-causal mechanisms that might explain these associations should be a priority.
Maternal Infections, Antibiotics, and Paracetamol in Pregnancy and Offspring Celiac Disease: A Cohort Study
TLDR
In this large pregnancy cohort of 84,274 children born in the period from 2000 to 2009, there was no clear association between maternal infections in pregnancy and offspring CD, but considering the marginal significance in some of the results maternal infections cannot be ruled out as a risk factor.
Prenatal Exposure to Acetaminophen and Childhood Asthmatic Symptoms in a Population-Based Cohort in Los Angeles, California
TLDR
Black/African American and Asian/Pacific Islander children showed a greater than two-fold risk for asthma diagnosis and wheezing associated with the exposure, and high maternal psychosocial stress also modified the exposure-outcome relationships.
Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study
TLDR
The main findings of this prospective birth cohort study add to previous observations linking prenatal and early postnatal paracetamol exposure to asthma development, and recommend par acetamol to remain the analgesic and antipyretic of choice throughout pregnancy and early childhood.
Prescribed analgesics in pregnancy and risk of childhood asthma
TLDR
It is proposed that analgesic use in pregnancy does not cause childhood asthma/wheeze and that the association is confounded by unmeasured factors that are intrinsic to the mother, such as chronic pain or anxiety.
Use of acetaminophen (paracetamol) during pregnancy and the risk of autism spectrum disorder in the offspring.
  • C. Andrade
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2016
TLDR
Whatever empirical data exist do not support the suggestion that the use of acetaminophen during pregnancy increases the risk of autism in the offspring, and this new finding suggests that the predisposition is toward the hyperkinetic syndrome rather than to autism.
Perinatal paracetamol exposure in mice does not affect the development of allergic airways disease in early life
TLDR
The mechanistic data do not support the hypothesis that prenatal paracetamol exposure increases the risk of childhood asthma, and the effects of maternal paracetAMol at any time point on airway remodelling or IgE levels are investigated.
Acetaminophen use in pregnancy: Examining prevalence, timing, and indication of use in a prospective birth cohort.
TLDR
Acetaminophen is used by the majority of pregnant women, and some continue to use for many weeks in pregnancy, but given the heterogeneity in duration of use, indication, and dose, studies that estimate the risk of adverse outcomes associated with acetaminophen must carefully consider these factors.
...
...

References

SHOWING 1-10 OF 56 REFERENCES
Paracetamol use in early life and asthma: prospective birth cohort study
TLDR
In children with a family history of allergic diseases, no association was found between early paracetamol use and risk of subsequent allergic disease after adjustment for respiratory infections or when paracetAMol use was restricted to non-respiratory tract infections.
Prenatal paracetamol exposure and asthma: further evidence against confounding.
TLDR
The findings suggest that the relation between maternal use of paracetamol in pregnancy and childhood asthma is unlikely to be confounded by unmeasured behavioural factors linked to par acetamol use.
Acetaminophen use and the risk of asthma in children and adults: a systematic review and metaanalysis.
TLDR
The results of this review are consistent with an increase in the risk of asthma and wheezing in both children and adults exposed to acetaminophen.
Prenatal Exposure to Acetaminophen and Asthma in Children
TLDR
The results suggest that acetaminophen use during pregnancy does not increase risk of asthma in children, and use during both the first and the third trimester was associated with a significantly reduced risk.
Pre-natal exposure to paracetamol and risk of wheezing and asthma in children: a birth cohort study.
TLDR
Paracetamol use during pregnancy was associated with an increased risk of asthma and wheezing in childhood, and if this association is causal, the clinical practice on use of par acetamol during pregnancy may need to be revisited.
Use of prescription paracetamol during pregnancy and risk of asthma in children: a population-based Danish cohort study
TLDR
A robust association was found between prenatal exposure to maternal use of prescription paracetamol and the risk of asthma; however, noncausal explanations could not be ruled out for such association.
Prenatal exposure to acetaminophen and respiratory symptoms in the first year of life.
  • V. Persky, J. Piorkowski, A. Busso
  • Medicine
    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
  • 2008
Frequent Use of Paracetamol and Risk of Allergic Disease Among Women in an Ethiopian Population
TLDR
This study provides further cross-sectional evidence that paracetamol use increases the risk of allergic disease.
Is the Effect of Prenatal Paracetamol Exposure on Wheezing in Preschool Children Modified by Asthma in the Mother?
TLDR
The frequent usage of paracetamol during pregnancy is associated with the prevalence of wheezing in offspring during preschool years, and asthma in the mother might modify this association.
...
...