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![Design, Setting, and Participants
This nationwide cohort study with sibling control analysis included a population-based sample of 2,480,797 children born in 1995 to 2019 in Sweden, with follow-up through December 31, 2021.
exposure
Use of acetaminophen during pregnancy prospectively recorded from antenatal and prescription records.
Main Outcomes and Measures
Autism, ADHD, and intellectual disability based on International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision codes in health registers.
Results
In total, 185909 children (7.49%) were exposed to acetaminophen during pregnancy. Crude absolute risks at 10 years of age for those not exposed vs those exposed to acetaminophen were 1.33% vs 1.53% for autism, 2.46% vs 2.87% for ADHD, and 0.70% vs 0.82% for intellectual disability. In models without sibling control, ever-use vs no use of acetaminophen during pregnancy was associated with marginally increased risk of autism (hazard ratio [HR], 1.05 [95% CI, 1.02-1.08]; risk difference [RD] at 10 years of age, 0.09% [95% Cl,
-0.01% to 0.20%l), ADHD (HR, 1.07 [95% Cl, 1.05-1.10];
RD, 0.21% [95% Cl, 0.08%-0.34%]), and intellectual disability (HR, 1.05 [95% CI, 1.00-1.10]; RD, 0.04% [95% Cl, -0.04% to 0.12%]).
To address unobserved confounding, matched full sibling pairs were also analyzed. Sibling control analyses found no evidence that acetaminophen use during pregnancy was associated with autism (HR, 0.98 [95% Cl, 0.93-1.04]; RD, 0.02% [95% Cl, -0.14% to 0.18%l), ADHD (HR, 0.98 |95% Cl, 0.94-1.02]; RD, -0.02% [95% Cl, -0.21% to 0.15%l), or intellectual disability (HR, 1.01 195% Cl, 0.92-1.10]; RD, 0% [95% Cl, -0.10% to 0.13%1).](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:llgfbjvsqkaicezsf7mzjxr3/bafkreic3ng7tamazingcwrsrq2jf6rtyvktttklcnxjs6dibuuhlyvi7bm@jpeg)
