Acetaminophen (Paracetamol)

Table   Graphic  
individual studies
OutcomeTE95% CIn casesn exposedkPub. bias Congenital malformations Gastroschisis Werler, 1992 Torfs, 1996 Werler, 2002 Rebordosa a, 2008 Feldkamp, 2010 Robledo-Aceves, 2015 Given, 2017 71.21[0.97; 1.51]96131,313not evaluable All congenital malformations (majors, minors, majors and minors, or unspecified) Nelson, 1971 Aselton, 1985 Thulstrup, 1999 Rebordosa a, 2008 Poletta, 2012 Broe (Controls unexposed, sick), 2025 61.09[0.93; 1.29]64,59439,950not evaluable Composite criterion: malformations of the genital system (cryptorchidism or hypospadias or clitoral hypertrophy or labial fusion, …) Rebordosa a, 2008 Jensen, 2010 Kristensen, 2011 Snijder, 2012 Lind, 2013 Fisher, 2016 Zafeiri, 2022 70.98[0.88; 1.08]2,83842,634not evaluable Cryptorchidism / Undescended testicle (minor malformation) Jensen, 2010 Kristensen, 2011 Snijder, 2012 Fisher, 2016 Zafeiri, 2022 51.04[0.88; 1.23]1,11412,808not evaluable Major congenital malformations Nelson, 1971 Rebordosa a, 2008 Poletta, 2012 Broe (Controls unexposed, sick), 2025 41.09[0.93; 1.27]63,50339,543not evaluable Congenital heart defects Zierler, 1985 Källén, 2003 Rebordosa a, 2008 31.05[0.97; 1.15]1,49163,333not evaluable Hypospadias Rebordosa a, 2008 Snijder, 2012 Lind, 2013 30.94[0.80; 1.10]1,72429,826not evaluable Cleft palate Puho, 2007 Rebordosa a, 2008 Feldkamp, 2010 31.23[0.90; 1.70]1,29928,669not evaluable Congenital constriction bands/amniotic band Werler, 2003 Feldkamp, 2010 21.32[0.74; 2.35]1979,013not evaluable Neural Tube Defects Pérez-Molina, 2002 Feldkamp, 2010 21.32[0.49; 3.54]8172,295not evaluable Respiratory system anomalies Rebordosa a, 2008 Broe (Controls unexposed, sick), 2025 21.46[0.69; 3.10]11535,014not evaluable Atresia or stenosis of other parts of small intestine Werler, 2002 Rebordosa a, 2008 20.96[0.61; 1.49]15026,801not evaluable Cardiac septal defects Rebordosa a, 2008 Feldkamp, 2010 21.04[0.94; 1.15]2,52529,390not evaluable Cleft lip with or without cleft palate Puho, 2007 Feldkamp, 2010 21.27[0.62; 2.60]2,4842,472not evaluable Congenital cataract Rebordosa a, 2008 Feldkamp, 2010 20.85[0.60; 1.20]15627,853not evaluable Congenital glaucoma Feldkamp, 2010 Cifuentes, 2025 21.61[0.81; 3.22]4135,925not evaluable Craniosynostosis Rebordosa a, 2008 Feldkamp, 2010 21.01[0.84; 1.21]57628,620not evaluable Eye defects Rebordosa a, 2008 Cifuentes, 2025 21.24[0.81; 1.88]4,29231,048not evaluable Nervous system anomalies Winship, 1984 Rebordosa a, 2008 20.85[0.61; 1.19]91526,465not evaluable Oro-facial clefts Rebordosa a, 2008 Feldkamp, 2010 21.03[0.92; 1.16]1,86229,136not evaluable Spina bifida Rebordosa a, 2008 Feldkamp, 2010 20.83[0.42; 1.63]47328,587not evaluable Ventricular septal defect Rebordosa a, 2008 Feldkamp, 2010 20.99[0.87; 1.13]1,16628,788not evaluable Abdominal wall defects Rebordosa a, 2008 10.76[0.24; 2.37]1926,424not evaluable Ano-rectal atresia and stenosis Feldkamp, 2010 10.85[0.68; 1.07]3652,111not evaluable Anophthalmos/micropthalmos Feldkamp, 2010 11.00[0.66; 1.52]1012,005not evaluable Anotia Feldkamp, 2010 11.01[0.76; 1.34]2442,054not evaluable Arhinencephaly/holoprosencephaly Feldkamp, 2010 11.69[0.91; 3.13]471,983not evaluable Atresia of bile ducts Feldkamp, 2010 10.61[0.35; 1.07]601,977not evaluable Atrial septal defect Feldkamp, 2010 11.06[0.92; 1.22]1,1992,560not evaluable Atrioventricular septal defect Feldkamp, 2010 10.90[0.60; 1.36]1042,005not evaluable Bilateral renal agenesis including Potter syndrome Feldkamp, 2010 11.01[0.58; 1.75]581,985not evaluable Bladder exstrophy and/or epispadia Feldkamp, 2010 11.69[0.80; 3.55]351,978not evaluable Choanal atresia Feldkamp, 2010 10.79[0.44; 1.41]531,979not evaluable Club foot / Talipes equinovarus Werler, 2014 10.98[0.79; 1.22]5701,009not evaluable Coarctation of aorta Feldkamp, 2010 10.88[0.71; 1.10]3962,144not evaluable Diaphragmatic hernia Feldkamp, 2010 11.15[0.90; 1.47]3002,109not evaluable Digestive system anomalies Rebordosa a, 2008 11.01[0.72; 1.41]18826,424not evaluable Ebstein's anomaly Feldkamp, 2010 11.22[0.70; 2.12]571,987not evaluable Encephalocele Feldkamp, 2010 10.98[0.61; 1.58]791,990not evaluable Eye, ear, face and neck malformations Rebordosa a, 2008 11.82[1.11; 2.99]7026,424not evaluable Genital anomalies Rebordosa a, 2008 11.06[0.82; 1.37]31326,424not evaluable Hip dislocation and/or dysplasia Rebordosa a, 2008 10.97[0.81; 1.16]64526,424not evaluable Hirschsprung's disease Rebordosa a, 2008 11.00[0.53; 1.88]4826,424not evaluable Hydrocephaly Feldkamp, 2010 10.92[0.67; 1.26]1812,040not evaluable Hypoplastic left heart (HLH/HLHS) Feldkamp, 2010 10.95[0.71; 1.28]2062,057not evaluable Limb defects Rebordosa a, 2008 11.02[0.91; 1.15]1,49526,424not evaluable Microcephaly / Small head circumference for gestational age Kerr, 2019 10.94[0.49; 1.81]574,625not evaluable Minor congenital malformations Nelson, 1971 10.71[0.15; 3.32]28311not evaluable Oesophageal atresia with or without tracheo-oesophageal fistula Feldkamp, 2010 10.96[0.73; 1.26]2652,080not evaluable Omphalocele Feldkamp, 2010 10.93[0.67; 1.29]1692,031not evaluable Pulmonary valve stenosis Feldkamp, 2010 11.11[0.91; 1.36]5082,223not evaluable Tetralogy of Fallot Feldkamp, 2010 11.05[0.84; 1.31]3952,147not evaluable Total anomalous pulm venous return Feldkamp, 2010 11.15[0.76; 1.75]1032,008not evaluable Transposition of the great vessels Feldkamp, 2010 11.10[0.87; 1.39]3422,127not evaluable Tricuspid atresia and stenosis Feldkamp, 2010 10.89[0.51; 1.55]591,983not evaluable Urinary malformations Rebordosa a, 2008 10.90[0.69; 1.18]30026,424not evaluable Growth parameters and prematurity Preterm (< 37 weeks) Thulstrup, 1999 Czeizel, 2005 Rebordosa, 2009 Arneja, 2020 Killion, 2022 De Castro, 2022 Sznajder, 2022 Zafeiri, 2022 Xu, 2024 Andreasen, 2025 101.05[0.82; 1.33]15,79127,511low Low birth weight (< 2500g) Thulstrup, 1999 Czeizel, 2005 Rebordosa, 2009 Arneja, 2020 De Castro, 2022 Sznajder, 2022 Zafeiri, 2022 Xu, 2024 81.10[0.83; 1.45]12,14526,123serious Small for gestational age (weight) Rebordosa, 2009 Arneja, 2020 Killion, 2022 De Castro, 2022 Sznajder, 2022 50.96[0.91; 1.01]6,1931,518not evaluable Macrosomia (> 4000g) Zafeiri, 2022 Xu, 2024 21.24[0.71; 2.16]16,02124,597not evaluable Very preterm (28 to 32 weeks) Rebordosa, 2009 10.96[0.82; 1.13]261-not evaluable Maternal consequences Preeclampsia Rebordosa, 2010 Killion, 2022 21.27[0.86; 1.87]1,20319,630not evaluable Caesarean Sznajder, 2022 11.29[1.09; 1.54]7121,011not evaluable Neonatal disorders Low Apgar score (< 7) (at 5 min) Sznajder, 2022 Zafeiri, 2022 Xu, 2024 31.55[0.92; 2.62]3,08125,536not evaluable Low Apgar score (< 7) (at 1 min) Zafeiri, 2022 Xu, 2024 21.90[0.73; 4.95]17,83924,531not evaluable Neonatal medical care Sznajder, 2022 Zafeiri, 2022 21.45[1.38; 1.52]15,08921,309not evaluable Cerebral palsy Petersen, 2018 11.34[1.05; 1.72]29290,830not evaluable Jaundice / Icterus Sznajder, 2022 11.18[0.97; 1.43]5401,011not evaluable Low Apgar score (< 7) (at 10 min) Xu, 2024 13.18[1.58; 6.41]60501not evaluable Neonatal death (< 28 days of life) Zafeiri, 2022 11.56[1.24; 1.96]49023,704not evaluable Neonatal intracranial hemorrhage Rumack, 1981 11.29[0.48; 3.49]4120not evaluable Long term consequences Childhood asthma Rebordosa b, 2008 Persky, 2008 Andersen, 2012 Magnus (Controls unexposed, NOS), 2016 Shaheen (Controls unexposed, general pop), 2019 Malaeb, 2021 Liew, 2021 71.34[1.18; 1.52]27,13015,601not evaluable Childhood wheezing Persky, 2008 Rebordosa b, 2008 Garcia-Marcos, 2009 Perzanowski, 2010 Goksor, 2011 Liew, 2021 61.24[1.09; 1.42]1,7828,539not evaluable Infant allergies Koniman, 2007 Jedrychowski, 2011 Li, 2021 31.18[0.88; 1.58]2,5465,331not evaluable Leukemia Ross, 2003 Ognjanovic, 2011 21.04[0.72; 1.50]504426not evaluable Child/Infant weight abnormalities (>= 1 year) Liew_Girls, 2019 Liew_Boys, 2019 21.06[0.98; 1.16]2,18713,681not evaluable Child/infant diabetes Type 1 Tapia, 2018 11.22[0.97; 1.53]162-not evaluable Child/infant digestive auto-immune diseases (Crohn, Coeliac disease , …) Marild, 2017 11.11[0.94; 1.31]61739,117not evaluable Intrauterine deaths Early intrauterine deaths (< 22 weeks) / Spontaneous abortions Li, 2003 Rebordosa, 2009 Li (Controls unexposed, NOS), 2018 31.03[0.92; 1.15]2,727563not evaluable Late intrauterine deaths (> 22 weeks) / Stillbirths Pastore, 1999 Rebordosa, 2009 Zafeiri, 2022 Xu, 2024 41.21[0.84; 1.73]1,68424,699not evaluable Neuro-developmental disorders ADHD (Attention deficit hyperactivity disorder): Diagnosis/Risk Liew, 2014 Ystrom or Gustavson (Ystrom - Population-Based), 2017 Tovo-Rodrigues, 2018 Chen, 2019 Sznajder, 2022 Ahlqvist (Population-Based), 2024 Okubo (Controls unexposed, general population), 2025 Pleau, 2025 81.16[1.09; 1.24]162,443323,950serious ADHD (Attention deficit hyperactivity disorder): Diagnosis Liew, 2014 Ystrom or Gustavson (Ystrom - Population-Based), 2017 Chen, 2019 Ahlqvist (Population-Based), 2024 Okubo (Controls unexposed, general population), 2025 Pleau, 2025 61.16[1.07; 1.25]161,166321,989serious ASD (Autism spectrum disorder): Diagnosis Liew b, 2016 Ahlqvist (Population-Based), 2024 Okubo (Controls unexposed, general population), 2025 31.07[1.02; 1.13]69,611264,219not evaluable ASD (Autism spectrum disorder): Diagnosis/Risk Liew b, 2016 Ahlqvist (Population-Based), 2024 Okubo (Controls unexposed, general population), 2025 31.07[1.02; 1.13]69,611264,219not evaluable Language disorders/delay Liew a, 2016 Bertoldi_Pelotas, 2020 Tovo-Rodrigues, 2020 Tronnes, 2020 Woodbury a, 2024 51.00[0.99; 1.01]1,4305,316not evaluable ADHD (Attention deficit hyperactivity disorder): Risk Tovo-Rodrigues, 2018 Inoue, 2021 Sznajder, 2022 31.15[1.06; 1.24]3,06923,631not evaluable Cognitive developmental disorders/delay (3-6 years old) Liew a, 2016 Okubo (Controls unexposed, general population), 2025 21.07[0.96; 1.19]-43,004not evaluable Psychomotor developmental disorders/delay Vlenterie, 2016 Tovo-Rodrigues, 2020 Bertoldi_Pelotas, 2020 31.04[0.82; 1.31]3214,100not evaluable Cognitive developmental disorders/delay (< 3 years old) Tovo-Rodrigues, 2020 Bertoldi_Pelotas, 2020 20.93[0.83; 1.03]-2,470not evaluable Cognitive developmental disorders/delay (> 6 years old) Ahlqvist (Population-Based), 2024 11.05[1.00; 1.10]24,554185,909not evaluable Neuro-developmental disorders (as a whole) Okubo (Controls unexposed, general population), 2025 11.08[1.01; 1.16]-42,123not evaluable Severe cognitive developmental delay (Mental retardation) (3-6 years old) Okubo (Controls unexposed, general population), 2025 11.03[0.91; 1.17]-42,123not evaluable Severe cognitive developmental delay (Mental retardation) (> 6 years old) Ahlqvist (Population-Based), 2024 11.05[1.00; 1.10]24,554185,909not evaluable ASD (Autism spectrum disorder): Risk Alemany_DNBC, 2021 11.28[1.10; 1.49]72934,584not evaluable Childhood autism (F84.0) Liew b, 2016 11.10[0.89; 1.36]34536,187not evaluable0.010.01.0

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