Prenatal Exposure to Acetaminophen and Childhood Asthmatic Symptoms in a Population-Based Cohort in Los Angeles, California

Zeyan Liew, Yuying Yuan, Qi Meng, Ondine S. von Ehrenstein, Xin Cui, Marie E. S. Flores and Beate Ritz
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Zeyan Liew: Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
Yuying Yuan: Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA
Qi Meng: Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA
Ondine S. von Ehrenstein: Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA
Xin Cui: Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, School of Medicine and Lucile Packard Children’s Hospital, Stanford University, Palo Alto, CA 94304, USA
Marie E. S. Flores: Department of Health Services, Altamed, Pico Rivera, CA 90660, USA
Beate Ritz: Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA 90095, USA

IJERPH, 2021, vol. 18, issue 19, 1-12

Abstract: Acetaminophen is the most common over-the-counter pain and fever medication used by pregnant women. While European studies suggest acetaminophen exposure in pregnancy could affect childhood asthma development, findings are less consistent in other populations. We evaluated whether maternal prenatal acetaminophen use is associated with childhood asthmatic symptoms (asthma diagnosis, wheeze, dry cough) in a Los Angeles cohort of 1201 singleton births. We estimated risk ratio (RR) and 95% confidence interval (CI) for childhood asthmatic outcomes according to prenatal acetaminophen exposure. Effect modification by maternal race/ethnicity and psychosocial stress during pregnancy was evaluated. The risks for asthma diagnosis (RR = 1.39, 95% CI 0.96, 2.00), wheezing (RR = 1.25, 95% CI 1.01, 1.54) and dry cough (RR =1.35, 95% CI 1.06, 1.73) were higher in children born to mothers who ever used acetaminophen during pregnancy compared with non-users. Black/African American and Asian/Pacific Islander children showed a greater than two-fold risk for asthma diagnosis and wheezing associated with the exposure. High maternal psychosocial stress also modified the exposure-outcome relationships. Acetaminophen exposure during pregnancy was associated with childhood asthmatic symptoms among vulnerable subgroups in this cohort. A larger study that assessed prenatal acetaminophen exposure with other social/environmental stressors and clinically confirmed outcomes is needed.

Keywords: acetaminophen; race/ethnicity; childhood asthma; psychosocial stress; pregnancy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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