Acetaminophen (Paracetamol) updated on 09-20-2024

Childhood wheezing

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.
S18602
R79075		 Liew, 2021 Wheezing - 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 1.25 [1.01;1.54] 118/393   186/808 304 393
ref
S18580
R78950		 Goksor, 2011 Recurrent wheeze (three or more episodes of wheezing during the last 12 months; Parental reported) - At 4.5 years of age during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires after pregnancy 1.10 [0.60;2.00] 23/334   212/4,017 235 334
ref
S18603
R79086		 Perzanowski, 2010 Current wheeze (wheeze in the previous 12months according to the validated ISAAC questionnaire) - Questionnaire administered to the mother - At age 5 years during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy 1.71 [1.20;2.42] -/103   -/198 - 103
ref
S18527
R78720		 Garcia-Marcos, 2009 Wheezing in children (parental report) - Children aged 3–5 years - At least once exposure during pregnancy during pregnancy (anytime or not specified) retrospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires after pregnancy 1.06 [0.79;1.41] 136/717   147/806 283 717
ref
S18526
R79174		 Persky, 2008 Any wheeze - 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 1.70 [1.00;3.00] -/240   -/103 - 240
ref
S18534
R78814		 Rebordosa b, 2008 Wheezing in the last 12 months (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 1.16 [0.99;1.35] 543/6,752   417/5,981 960 6,752
ref
Total 6 studies 1.24 [1.09;1.42] 1,782 8,539
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 Liew, 2021Liew, 2021 1.25[1.01; 1.54]30439326%ROB confusion: seriousROB selection: unclearROB classification: criticalROB missing: moderateROB mesure: criticalROB reporting: moderate Goksor, 2011Goksor, 2011 1.10[0.60; 2.00]2353344%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: criticalROB mesure: criticalROB reporting: critical Perzanowski, 2010Perzanowski, 2010 1.71[1.20; 2.42]-10312%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: moderateROB mesure: criticalROB reporting: moderate Garcia-Marcos, 2009Garcia-Marcos, 2009 1.06[0.79; 1.41]28371716%ROB confusion: criticalROB selection: unclearROB classification: criticalROB missing: unclearROB mesure: criticalROB reporting: moderate Persky, 2008Persky, 2008 1.70[1.00; 3.00]-2405%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: moderateROB mesure: criticalROB reporting: moderate Rebordosa b, 2008Rebordosa b, 2008 1.16[0.99; 1.35]9606,75237%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: moderateROB mesure: criticalROB reporting: moderate Total (6 studies) I2 = 22% 1.24[1.09; 1.42]1,7828,5390.55.01.0ROB: 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 1.24[1.09; 1.42]1,7828,53922%NALiew, 2021 Goksor, 2011 Perzanowski, 2010 Garcia-Marcos, 2009 Persky, 2008 Rebordosa b, 2008 6 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.24[1.09; 1.42]1,7828,53922%NALiew, 2021 Goksor, 2011 Perzanowski, 2010 Garcia-Marcos, 2009 Persky, 2008 Rebordosa b, 2008 6 Tags Adjustment   - Yes  - Yes 1.24[1.09; 1.42]1,7828,53922%NALiew, 2021 Goksor, 2011 Perzanowski, 2010 Garcia-Marcos, 2009 Persky, 2008 Rebordosa b, 2008 6 Paracetamol use   - maternal ITW/questionnaires after p ...  - maternal ITW/questionnaires after pregnancy 1.17[1.00; 1.38]8221,4440%NALiew, 2021 Goksor, 2011 Garcia-Marcos, 2009 3   - maternal ITW/questionnaires during ...  - maternal ITW/questionnaires during pregnancy 1.42[1.04; 1.92]9607,09561%NAPerzanowski, 2010 Persky, 2008 Rebordosa b, 2008 3 All studiesAll studies 1.24[1.09; 1.42]1,7828,53922%NALiew, 2021 Goksor, 2011 Perzanowski, 2010 Garcia-Marcos, 2009 Persky, 2008 Rebordosa b, 2008 60.55.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-0.70.90.3690.000Liew, 2021Goksor, 2011Perzanowski, 2010Garcia-Marcos, 2009Persky, 2008Rebordosa b, 2008

Asymetry test p-value = 0.3659 (by Egger's regression)

slope=0.0735 (0.1404); intercept=1.0870 (1.0670); t=1.0188; p=0.3659

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) 1.24[1.09; 1.42]1,7828,53922%NALiew, 2021 Goksor, 2011 Perzanowski, 2010 Garcia-Marcos, 2009 Persky, 2008 Rebordosa b, 2008 60.510.01.0

Umbrella review (other published meta-analyses)

Published MAControlPeriodTE95% CIn exposedkI2 Fan (Child asthma risk (asthma/wheeze together))Fan (Child asthma risk (asthma/wheeze together)) 1.19[1.12; 1.27]41%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT13 Fan (Child asthma risk (asthma/wheeze together))Fan (Child asthma risk (asthma/wheeze together)) 1.21[1.14; 1.28]0%-Wwhatever (meta-analysis)T11st trimesterstudies TTT6 Fan (Child asthma risk (asthma/wheeze together))Fan (Child asthma risk (asthma/wheeze together)) 1.13[1.04; 1.23]33%-Wwhatever (meta-analysis)T2-T32nd and/or 3rd trimesterstudies TTT7 Baranska (Childhood wheeze)Baranska (Childhood wheeze) 1.04[0.78; 1.37]81%-Wwhatever (meta-analysis)T11st trimesterstudies TTT3 Baranska (Childhood wheeze)Baranska (Childhood wheeze) 0.95[0.82; 1.10]0%-Wwhatever (meta-analysis)T22nd trimesterstudies TTT2 Baranska (Childhood wheeze)Baranska (Childhood wheeze) 1.11[0.92; 1.34]58%-Wwhatever (meta-analysis)T22nd trimesterstudies TTT3 Baranska (Childhood wheeze)Baranska (Childhood wheeze) 1.31[1.12; 1.54]75%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT8 Eyers (Current wheeze (and/or asthma))Eyers (Current wheeze (and/or asthma)) 1.21[1.02; 1.44]76%-Wwhatever (meta-analysis)Anyduring pregnancy (anytime or not specified)studies TTT6 metaPregmetaPreg 1.24[1.09; 1.42]22%8,539----Liew, 2021 Goksor, 2011 Perzanowski, 2010 Garcia-Marcos, 2009 Persky, 2008 Rebordosa b, 2008 60.510.01.0