Abstract：
OBJECTIVE: To investigate whether maternal paracetamol use in early pregnancy is associated with cerebral palsy (CP) in offspring.
METHODS: We conducted a registry and biobank-based case-control study with mother-child pairs. We identified CP cases (n = 322) born between 1995 and 2014 from a nationwide CP-registry. Randomly selected controls (n = 343) and extra preterm controls (n = 258) were obtained from a birth registry. For each mother, a single serum sample from early pregnancy (gestation weeks 10-14) was retrieved from a biobank and analyzed for serum concentrations of paracetamol, categorized into unexposed (<1 ng/ml), mildly exposed (1-100 ng/ml), and highly exposed (>100 ng/ml), and in quartiles. Analyses were performed using logistic regression and adjusted for potential confounders. Separate analyses were conducted including only those children born preterm and only those born term.
RESULTS: Of the 923 participants, 36.8% were unexposed, 53.2% mildly exposed, and 10% highly exposed to paracetamol. Overall, prenatal exposure to paracetamol was not associated with CP. Sensitivity and subgroup analyses showed no clear associations between paracetamol and CP across strata of term/preterm birth as well as subtypes of CP.
CONCLUSIONS: The present study does not support an association between intrauterine exposure to paracetamol in early pregnancy and the risk of CP. However, it is important to stress that the exposure estimate is based on a single serum sample.
METHODS: We conducted a registry and biobank-based case-control study with mother-child pairs. We identified CP cases (n = 322) born between 1995 and 2014 from a nationwide CP-registry. Randomly selected controls (n = 343) and extra preterm controls (n = 258) were obtained from a birth registry. For each mother, a single serum sample from early pregnancy (gestation weeks 10-14) was retrieved from a biobank and analyzed for serum concentrations of paracetamol, categorized into unexposed (<1 ng/ml), mildly exposed (1-100 ng/ml), and highly exposed (>100 ng/ml), and in quartiles. Analyses were performed using logistic regression and adjusted for potential confounders. Separate analyses were conducted including only those children born preterm and only those born term.
RESULTS: Of the 923 participants, 36.8% were unexposed, 53.2% mildly exposed, and 10% highly exposed to paracetamol. Overall, prenatal exposure to paracetamol was not associated with CP. Sensitivity and subgroup analyses showed no clear associations between paracetamol and CP across strata of term/preterm birth as well as subtypes of CP.
CONCLUSIONS: The present study does not support an association between intrauterine exposure to paracetamol in early pregnancy and the risk of CP. However, it is important to stress that the exposure estimate is based on a single serum sample.
摘要：
目的：探讨孕早期孕妇服用扑热息痛是否与后代脑瘫（CP）相关。
方法：我们进行了一项基于注册和生物库的病例对照研究，对母子进行了研究。我们从全国CP注册中确定了1995-2014年之间出生的CP病例（n=322）。从出生登记处获得随机选择的对照（n=343）和额外的早产对照（n=258）。对于每个母亲来说，从早期妊娠（妊娠10-14周）的单一血清样本从生物库检索和分析对乙酰氨基酚的血清浓度，归类为未暴露（<1ng/ml），轻度暴露（1-100ng/ml），和高度暴露（>100纳克/毫升），还有四分位数.使用逻辑回归进行分析，并校正潜在的混杂因素。进行了单独的分析，仅包括早产的儿童和足月出生的儿童。
结果：在923名参与者中，36.8%的人没有暴露，53.2%轻度暴露,10%的人高度暴露于扑热息痛。总的来说,产前对乙酰氨基酚暴露与CP无关.敏感性和亚组分析显示，在足月/早产以及CP亚型之间，对乙酰氨基酚和CP之间没有明显的关联。
结论：本研究不支持妊娠早期宫内暴露于扑热息痛与CP风险之间的关系。然而,必须强调的是,暴露估计是基于单一血清样本.
方法：我们进行了一项基于注册和生物库的病例对照研究，对母子进行了研究。我们从全国CP注册中确定了1995-2014年之间出生的CP病例（n=322）。从出生登记处获得随机选择的对照（n=343）和额外的早产对照（n=258）。对于每个母亲来说，从早期妊娠（妊娠10-14周）的单一血清样本从生物库检索和分析对乙酰氨基酚的血清浓度，归类为未暴露（<1ng/ml），轻度暴露（1-100ng/ml），和高度暴露（>100纳克/毫升），还有四分位数.使用逻辑回归进行分析，并校正潜在的混杂因素。进行了单独的分析，仅包括早产的儿童和足月出生的儿童。
结果：在923名参与者中，36.8%的人没有暴露，53.2%轻度暴露,10%的人高度暴露于扑热息痛。总的来说,产前对乙酰氨基酚暴露与CP无关.敏感性和亚组分析显示，在足月/早产以及CP亚型之间，对乙酰氨基酚和CP之间没有明显的关联。
结论：本研究不支持妊娠早期宫内暴露于扑热息痛与CP风险之间的关系。然而,必须强调的是,暴露估计是基于单一血清样本.
