Acetaminophen (Paracetamol) updated on 09-20-2024

Language disorders/delay

R analysis
id Study   Lib. in paper Exposition period    Study type  Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S16660
R70014
Woodbury a, 2024 Expressive vocabulary score (≤25th percentile) - MacArthur-Bates Communicative Development Inventories (CDI) Parent's report - Average age of 27.42 (±1.08) months during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy 1.00 [0.99;1.01] -/208   -/90 - 208
ref
S16657
R69971
Bertoldi_Pelotas, 2020 Cognitive development (Language) - INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) - Mean (SD) 2.0 (0.06) years (Acetaminophen 1st, 2nd, or 3rd trim) during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No extrapolated (cont. endpoint) Paracetamol use: maternal ITW/questionnaires during pregnancy 1.00 [0.89;1.13] -/2,470   -/1,348 - 2,470
ref
S16648
R69902
Tovo-Rodrigues, 2020 Communication area (< 10th percentile) - Battelle's Developmental Inventory - At 24 months during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires after pregnancy 1.04 [0.84;1.30] -/-   -/- - -
ref
S16654
R69944
Tronnes, 2020 Communication problems (T scores ≥65) - The Ages and Stages Questionnaire (ASQ), Parents completed - At 5 years (use in three trimesters) during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy 1.18 [0.86;1.60] 149/1,757   1,281/17,317 1,430 1,757
ref
S16642
R69844
Liew a, 2016 Verbal IQ - Wechsler Primary and Preschool Scales of intelligence-revised (WPPSi-r) - 5 years old during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes extrapolated (cont. endpoint) Paracetamol use: maternal ITW/questionnaires during pregnancy 1.08 [0.90;1.31] -/881   -/610 - 881
ref
Total 5 studies 1.00 [0.99;1.01] 1,430 5,316
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

StudyTE95% CIn casesn exposedweightROBABCDEF Woodbury a, 2024Woodbury a, 2024 1.00[0.99; 1.01]-20899%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: criticalROB mesure: criticalROB reporting: moderate Bertoldi_Pelotas, 2020Bertoldi_Pelotas, 2020 1.00[0.89; 1.13]-2,4701%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Tovo-Rodrigues, 2020Tovo-Rodrigues, 2020 1.04[0.84; 1.30]--0%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Tronnes, 2020Tronnes, 2020 1.18[0.86; 1.60]1,4301,7570%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Liew a, 2016Liew a, 2016 1.08[0.90; 1.31]-8810%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 0% 1.00[0.99; 1.01]1,4305,3160.55.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.00[0.99; 1.01]1,4305,3160%NAWoodbury a, 2024 Bertoldi_Pelotas, 2020 Tovo-Rodrigues, 2020 Tronnes, 2020 Liew a, 2016 5 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.00[0.99; 1.01]1,4305,3160%NAWoodbury a, 2024 Bertoldi_Pelotas, 2020 Tovo-Rodrigues, 2020 Tronnes, 2020 Liew a, 2016 5 Tags Adjustment   - No  - No 1.00[0.89; 1.13]-2,470 -NABertoldi_Pelotas, 2020 1   - Yes  - Yes 1.00[0.99; 1.01]1,4302,8460%NAWoodbury a, 2024 Tovo-Rodrigues, 2020 Tronnes, 2020 Liew a, 2016 4 extrapolated (cont. endpoint)extrapolated (cont. endpoint) 1.02[0.92; 1.13]-3,3510%NABertoldi_Pelotas, 2020 Liew a, 2016 2 Paracetamol use   - maternal ITW/questionnaires after p ...  - maternal ITW/questionnaires after pregnancy 1.04[0.84; 1.29]-- -NATovo-Rodrigues, 2020 1   - maternal ITW/questionnaires during ...  - maternal ITW/questionnaires during pregnancy 1.00[0.99; 1.01]1,4305,3160%NAWoodbury a, 2024 Bertoldi_Pelotas, 2020 Tronnes, 2020 Liew a, 2016 4 All studiesAll studies 1.00[0.99; 1.01]1,4305,3160%NAWoodbury a, 2024 Bertoldi_Pelotas, 2020 Tovo-Rodrigues, 2020 Tronnes, 2020 Liew a, 2016 50.55.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-0.40.40.1900.000Woodbury a, 2024Bertoldi_Pelotas, 2020Tovo-Rodrigues, 2020Tronnes, 2020Liew a, 2016

Asymetry test p-value = 0.1102 (by Egger's regression)

slope=0.0000 (0.0028); intercept=0.5568 (0.2477); t=2.2477; p=0.1102

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.00[0.99; 1.01]1,4305,3160%NAWoodbury a, 2024 Bertoldi_Pelotas, 2020 Tovo-Rodrigues, 2020 Tronnes, 2020 Liew a, 2016 50.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Bérard (Language developmental disorder/delay)Bérard (Language developmental disorder/delay) 1.00[0.99; 1.01]0%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT5 metaPregmetaPreg 1.00[0.99; 1.01]0%5,316----Woodbury a, 2024 Bertoldi_Pelotas, 2020 Tovo-Rodrigues, 2020 Tronnes, 2020 Liew a, 2016 50.510.01.0