Acetaminophen (Paracetamol) updated on 09-20-2024

Childhood asthma

id	Study   Auto Liew, 2021Malaeb, 2021Shaheen (Controls unexposed, general pop), 2019Shaheen (Controls unexposed, sibling), 2019Magnus (Controls exposed to ibuprofen), 2016Magnus (Controls unexposed, NOS), 2016Andersen, 2012Persky, 2008Rebordosa b, 2008	Lib. in paper	Exposition period  Auto during pregnancy (anytime or not specified)1st trimester2nd trimester3rd trimester2nd and/or 3rd trimesterthroughout pregnancyearly pregnancydays before deliverylate pregnancypreconception-onlypericonceptionalpreconceptional for kinetic reasonat least 1st trimester3 months (or more) before pregnancy or during pregnancy1st and 2nd trimester3 months or more before pregnancy or1st trimesterPaternal exp. genotoxic window only (0–3 months preconception)Paternal exposure: epigenetic window only (3–xxx months preconception)Paternal exposure: genotoxic/epigenetic window (0–xxx months preconception)Paternal exposure: other window	Study type  All studies Case control excluded Only case control	Control type    Auto unexposed (general population or NOS)unexposed, sickunexposed, disease freeexposed to other treatment, sicknot specifiedsiblingwhatever (meta-analysis)	Tags	OR 95%CI	x1/n1 x0/n0	no cases	no exposed	ROB	Ref.
S18602 R79074	Liew, 2021	Asthma Diagnosis - Maternal report according to the International Study of Asthma and Allergies in Childhood (ISAAC) core questionnaire - At 3 to 4 years of age	during pregnancy (anytime or not specified)	retrospective cohort	unexposed (general population or NOS)	Adjustment: Yes Paracetamol use: maternal ITW/questionnaires after pregnancy	1.38 [0.96;1.98]	47/393   71/808	118	393		ref
S18558 R79329	Malaeb, 2021	Diagnosed asthma - Diagnosed asthma with symptoms (chronic wheezing, cough, and dyspnea), and an affirmative answer to the question 'did your doctor ever tell you that your child has asthma?' - Mean age 10.3 years old	during pregnancy (anytime or not specified)	case control	unexposed (general population or NOS)	Adjustment: Yes Paracetamol use: maternal ITW/questionnaires after pregnancy	4.66 [1.92;11.30]	-/-   0/-	-	-		ref
S18510 R78649	Shaheen (Controls unexposed, general pop), 2019	Childhood asthma/wheeze - At 6 years of age (ICD-10 (J45 and J46) and asthma prescribed medications for children < 4.5 years; ICD-10 (J45 and J46) or asthma prescribed medications for children > 4.5 years)	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Paracetamol use: prescription or medical files	1.46 [1.23;1.72]	194/-   -/-	-	-		ref
S18511 R78652	Shaheen (Controls unexposed, sibling), 2019	Childhood asthma/wheeze - At 4 years of age (ICD-10 (J45 and J46) and asthma prescribed medications for children < 4.5 years; ICD-10 (J45 and J46) or asthma prescribed medications for children > 4.5 years)	during pregnancy (anytime or not specified)	population based cohort retrospective	sibling excluded	Adjustment: Yes Paracetamol use: prescription or medical files	0.80 [0.50;1.29] excluded (control group)	-/-   -/-	-	-		ref
S18579 R78948	Magnus (Controls exposed to ibuprofen), 2016	Current asthma (three positive criteria reported in the 7-year questionnaire: a positive report of ever asthma, experiencing asthma symptoms during the past year and using medications for asthma in the past year) - At 7 years (Parental reported)	during pregnancy (anytime or not specified)	prospective cohort	exposed to other treatment, sick excluded	Adjustment: No Paracetamol use: maternal ITW/questionnaires during pregnancy	1.23 [0.77;1.96] C excluded (control group)	647/10,608   19/378	666	10,608		ref
S18578 R78945	Magnus (Controls unexposed, NOS), 2016	Current asthma (three positive criteria reported in the 7-year questionnaire: a positive report of ever asthma, experiencing asthma symptoms during the past year and using medications for asthma in the past year) - At 7 years (Parental reported)	during pregnancy (anytime or not specified)	prospective cohort	unexposed (general population or NOS)	Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy	1.27 [1.09;1.47]	405/7,240   386/9,905	791	7,240		ref
S18517 R78683	Andersen, 2012	Asthma in offspring (at least two prescriptions of both a β-agonist and an inhaled glucocorticoid and/or a hospital diagnosis of asthma) - Median follow-up time 6.8 years	during pregnancy (anytime or not specified)	population based cohort retrospective	unexposed (general population or NOS)	Adjustment: Yes Negative controls: confusion biais +++ Paracetamol use: prescription or medical files	1.35 [1.17;1.57]	176/976   24,330/196,084	24,506	976		ref
S18526 R79179	Persky, 2008	Asthma diagnosis - Maternal reported - By the age of 1 year	during pregnancy (anytime or not specified)	retrospective cohort	unexposed (general population or NOS)	Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy	1.60 [0.40;6.40]	-/240   -/103	-	240		ref
S18534 R78813	Rebordosa b, 2008	Physician-diagnosed asthma/bronchitis (Maternal reported) - At 7-year-old	during pregnancy (anytime or not specified)	prospective cohort	unexposed (general population or NOS)	Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy	1.15 [1.02;1.29]	886/6,752   644/5,981	1,530	6,752		ref
					Total	7 studies	1.34 [1.18;1.52]		26,945	15,601
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

Sensitivity analysis

Publication bias and p-hacking diagnosis

Sub-groups analysis using all included studies

excluded 18579, 18511

Umbrella review (other published meta-analyses)