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KMID : 1161220240670030126
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Clinical and Experimental Pediatrics
2024 Volume.67 No. 3 p.126 ~ p.139
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Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy
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Lisa Zhao
John P. Jones III
Lauren G. Anderson
Zacharoula Konsoula
Cynthia D. Nevison
Kathryn J. Reissner
William Parker
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Abstract
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Despite the worldwide acceptance of acetaminophen(APAP) as a necessary medicine in pediatrics, evidence that early exposure to APAP causes neurodevelopmental injury in susceptible babies and children has been mounting for over a decade.
The evidence is diverse and includes extensive work with laboratory animals, otherwise unexplained associations, factors associated with APAP metabolism, and limited studies in humans. Although the evidence has reached an overwhelming level and was recently reviewed in detail, controversy persists. This narrative review evaluates some of that controversy.
Evidence from the pre- and postpartum periods was considered to avoidcontroversy raised by consideration of only limited evidence of risks during the prepartum period. Among other issues, the association between APAP use and the prevalence of neurodevelopmental disorders was considered.
A systematic review revealed that the use of APAP in the pediatric population was never tracked carefully; however, historical events that affected its use were documented and are sufficient to establish apparent correlations with changes in the prevalence of neurodevelopmental disorders. Moreover, problems with the exclusive reliance on results of meta-analyses of large datasets with limited timeframes of drug exposure were reviewed.
Furthermore, the evidence of why some children are susceptible to APAP induced neurodevelopmental injuries was examined. We concluded that available evidence demonstrates that early exposure to APAP causes neurodevelopmental injury insusceptible babies and small children.
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KEYWORD
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Acetaminophen, Autism, Neurodevelopment, Paracetamol
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