Abstract：
Paracetamol is the most commonly used antipyretic and analgesic in pregnancy. It is also increasingly used off-label in the neonatal intensive care unit. Despite the frequent use of paracetamol, concerns have been raised regarding the high variability in neonatal dosing regimens and the long-term safety of early life exposure.
To investigate the available evidence on the long-term safety of prenatal and neonatal paracetamol exposure.
We conducted a systematic search of the electronic databases Ovid Medline, Ovid Embase and Web of Science from inception to August 2021 for original research studies of any design that described the use of paracetamol in the prenatal or neonatal (within the first four weeks of life) periods and examined the occurrence of neurodevelopmental, atopic or reproductive adverse outcomes at or beyond birth.
We identified 1313 unique articles and included 30 studies in the final review. Of all studies, 27 (90%), two (7%) and one (3%) were on the long-term safety of prenatal, neonatal and both prenatal and neonatal exposure, respectively. Thirteen (46%), 11 (39%) and four (15%) studies examined neurodevelopmental, atopic and reproductive outcomes. Eleven (100%), 11 (100%), and three (27%) studies on prenatal exposure reported adverse neurodevelopmental, atopic and reproductive outcomes. Only one study found a possible correlation between neonatal paracetamol exposure and long-term adverse outcomes.
The available evidence, although limited, suggests a possible association between prenatal paracetamol exposure and an increased risk of neurodevelopmental, atopic and reproductive adverse outcomes. There is an immediate need for robust data on the long-term safety of paracetamol exposure in the prenatal and neonatal periods.
To investigate the available evidence on the long-term safety of prenatal and neonatal paracetamol exposure.
We conducted a systematic search of the electronic databases Ovid Medline, Ovid Embase and Web of Science from inception to August 2021 for original research studies of any design that described the use of paracetamol in the prenatal or neonatal (within the first four weeks of life) periods and examined the occurrence of neurodevelopmental, atopic or reproductive adverse outcomes at or beyond birth.
We identified 1313 unique articles and included 30 studies in the final review. Of all studies, 27 (90%), two (7%) and one (3%) were on the long-term safety of prenatal, neonatal and both prenatal and neonatal exposure, respectively. Thirteen (46%), 11 (39%) and four (15%) studies examined neurodevelopmental, atopic and reproductive outcomes. Eleven (100%), 11 (100%), and three (27%) studies on prenatal exposure reported adverse neurodevelopmental, atopic and reproductive outcomes. Only one study found a possible correlation between neonatal paracetamol exposure and long-term adverse outcomes.
The available evidence, although limited, suggests a possible association between prenatal paracetamol exposure and an increased risk of neurodevelopmental, atopic and reproductive adverse outcomes. There is an immediate need for robust data on the long-term safety of paracetamol exposure in the prenatal and neonatal periods.
摘要：
扑热息痛是妊娠期最常用的解热镇痛药。在新生儿重症监护病房中，它也越来越多地用于标签外。尽管经常使用扑热息痛，对新生儿给药方案的高变异性和早期暴露的长期安全性提出了担忧.
目的研究产前和新生儿服用扑热息痛的长期安全性的现有证据。
我们对OvidMedline电子数据库进行了系统搜索，OvidEmbase和WebofScience从成立到2021年8月，用于任何设计的原始研究研究，这些设计描述了对乙酰氨基酚在产前或新生儿（生命的前四周）中的使用，并检查了神经发育的发生，出生时或出生后的特应性或生殖不良结局。
我们确定了1313篇独特的文章，并在最终审查中纳入了30项研究。在所有的研究中,27（90%），两个（7％）和一个（3％）对产前的长期安全性，新生儿以及产前和新生儿暴露，分别。十三（46%），11项(39%)和四项(15%)研究检查了神经发育，特应性和生殖结果。11(100%),11（100%），三项(27%)产前暴露研究报告了不良的神经发育，特应性和生殖结果。只有一项研究发现新生儿对乙酰氨基酚暴露与长期不良结局之间可能存在相关性。
现有证据,虽然有限，提示产前扑热息痛暴露与神经发育风险增加之间可能存在关联，特应性和生殖不良结局。迫切需要有关产前和新生儿时期对乙酰氨基酚暴露的长期安全性的可靠数据。
目的研究产前和新生儿服用扑热息痛的长期安全性的现有证据。
我们对OvidMedline电子数据库进行了系统搜索，OvidEmbase和WebofScience从成立到2021年8月，用于任何设计的原始研究研究，这些设计描述了对乙酰氨基酚在产前或新生儿（生命的前四周）中的使用，并检查了神经发育的发生，出生时或出生后的特应性或生殖不良结局。
我们确定了1313篇独特的文章，并在最终审查中纳入了30项研究。在所有的研究中,27（90%），两个（7％）和一个（3％）对产前的长期安全性，新生儿以及产前和新生儿暴露，分别。十三（46%），11项(39%)和四项(15%)研究检查了神经发育，特应性和生殖结果。11(100%),11（100%），三项(27%)产前暴露研究报告了不良的神经发育，特应性和生殖结果。只有一项研究发现新生儿对乙酰氨基酚暴露与长期不良结局之间可能存在相关性。
现有证据,虽然有限，提示产前扑热息痛暴露与神经发育风险增加之间可能存在关联，特应性和生殖不良结局。迫切需要有关产前和新生儿时期对乙酰氨基酚暴露的长期安全性的可靠数据。
