Acetaminophen (Neuro-developmental outcomes) updated on 07-16-2024

ADHD (Attention deficit hyperactivity disorder): Risk

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.
S16320
R67429		 Sznajder, 2022 Attention problems (> 80th percentile score) - Subscale of CBCL - At 3 years old during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy 1.21 [1.01;1.45] 330/1,002   391/1,398 721 1,002
ref
S16314
R67574		 Inoue, 2021 Hyperactivity (score ≥7) - Subdomain of Strengths and Difficulties Questionnaire (SDQ) Parent-reported - At 11 years old during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires during pregnancy 1.12 [1.02;1.24] 1,043/21,670   749/19,264 1,792 21,670
ref
S16276
R67787		 Tovo-Rodrigues, 2018 Hyperactivity/inattention - Strengths and Difficulties Questionnaire (SDQ score ≥ 7 pts), Psychologists administration to parents - At 11 years old during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: Yes Paracetamol use: maternal ITW/questionnaires after pregnancy 1.20 [0.96;1.49] 165/959   391/2,488 556 959
ref
Total 3 studies 1.15 [1.06;1.24] 3,069 23,631
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 Sznajder, 2022Sznajder, 2022 1.21[1.01; 1.45]7211,00220%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: criticalROB mesure: criticalROB reporting: moderate Inoue, 2021Inoue, 2021 1.12[1.02; 1.24]1,79221,67067%ROB confusion: moderateROB selection: lowROB classification: moderateROB missing: moderateROB mesure: criticalROB reporting: moderate Tovo-Rodrigues, 2018Tovo-Rodrigues, 2018 1.20[0.96; 1.49]55695913%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: moderateROB mesure: criticalROB reporting: moderate Total (3 studies) I2 = 0% 1.15[1.06; 1.24]3,06923,6310.55.01.0ROB: 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 1.15[1.06; 1.24]3,06923,6310%NASznajder, 2022 Inoue, 2021 Tovo-Rodrigues, 2018 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 1.15[1.06; 1.24]3,06923,6310%NASznajder, 2022 Inoue, 2021 Tovo-Rodrigues, 2018 3 Tags Adjustment   - Yes  - Yes 1.15[1.06; 1.24]3,06923,6310%NASznajder, 2022 Inoue, 2021 Tovo-Rodrigues, 2018 3 Paracetamol use   - maternal ITW/questionnaires after p ...  - maternal ITW/questionnaires after pregnancy 1.20[0.96; 1.49]556959 -NATovo-Rodrigues, 2018 1   - maternal ITW/questionnaires during ...  - maternal ITW/questionnaires during pregnancy 1.14[1.05; 1.24]2,51322,6720%NASznajder, 2022 Inoue, 2021 2 All studiesAll studies 1.15[1.06; 1.24]3,06923,6310%NASznajder, 2022 Inoue, 2021 Tovo-Rodrigues, 2018 30.55.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

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

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

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) 1.15[1.06; 1.24]3,06923,6310%NASznajder, 2022 Inoue, 2021 Tovo-Rodrigues, 2018 30.510.01.0