Maternal paracetamol use during 18 to 32 weeks of gestation is associated with a higher risk for attention problems and hyperactivity in children 42 to 47 months of age, particularly boys, a study in Paediatric and Perinatal Epidemiology suggests.

The study analyzed pregnancy data from the Avon Longitudinal Study of Parents and Children (ALSPAC), collected at 32-weeks’ gestation and with a focus on the period between 18 to 32 weeks (n=12,418). Paracetamol use was determined from the results of a questionnaire sent to study participants. The researchers identified approximately 43.9% of women in the dataset who reported having taken paracetamol during this period.

An assessment of biologic markers, physiologic and psychiatric tests, and neurocognitive measures was performed. After this, the researchers performed a regression analysis to assess associations between paracetamol exposure during pregnancy and child outcomes.

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A total of 15 factors had an independent association with paracetamol exposure during pregnancy. The “Freedom from distractibility” subset of IQ measured at age 8 was one such factor (mean difference (MD), −0.35; 95% CI, −0.70 to −0.00; Ptrend =.048). Adaptability (MD, 0.33; 95% CI, 0.05-0.60; Ptrend =.019) at 6 months and persistence (MD, 0.36; 95% CI, 0.12-0.60; Ptrend =.003) at 24 months were also factors associated with paracetamol that retained significance after adjustment.

Another association was between paracetamol exposure and attention as evaluated by a teacher in school year 3 (MD, 0.45; 95% CI, 0.11-0.79; Ptrend =.009). Overall, boys exposed to paracetamol during gestation tended to have more conduct problems, troublesome behaviors, and hyperactivity.

The researchers suggested that a limitation of the study was the lack of adjustment for residual confounding which, if present, may have led to variations in the findings.

“Given the increase in these behaviors it will be important to assess whether they are accompanied by difficulties in scholastic achievements,” the researchers wrote, “or whether any adverse effects survive puberty.”


Golding J, Gregory S, Clark R, Ellis G, Iles-Caven Y, Northstone K. Associations between paracetamol (acetaminophen) intake between 18 and 32 weeks gestation and neurocognitive outcomes in the child: a longitudinal cohort study [published online September 15, 2019]. Paediatr Perinat Epidemiol. doi:10.1111/ppe.12582