The potential etiological role of early acetaminophen exposure on Autism Spectrum Conditions (ASC) and Attention-Deficit/Hyperactivity Disorder (ADHD) is inconclusive. We aimed to study this association in a collaborative study of six European population-based birth/child cohorts. A total of 73,881 mother–child pairs were included in the study. Prenatal and postnatal (up to 18 months) acetaminophen exposure was assessed through maternal questionnaires or interviews. ASC and ADHD symptoms were assessed at 4–12 years of age using validated instruments. Children were classified as having borderline/clinical symptoms using recommended cutoffs for each instrument. Hospital diagnoses were also available in one cohort. Analyses were adjusted for child and maternal characteristics along with indications for acetaminophen use. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. The proportion of children having borderline/clinical symptoms ranged between 0.9 and 12.9% for ASC and between 1.2 and 12.2% for ADHD. Results indicated that children prenatally exposed to acetaminophen were 19% and 21% more likely to subsequently have borderline or clinical ASC (OR = 1.19, 95% CI 1.07–1.33) and ADHD symptoms (OR = 1.21, 95% CI 1.07–1.36) compared to non-exposed children. Boys and girls showed higher odds for ASC and ADHD symptoms after prenatal exposure, though these associations were slightly stronger among boys. Postnatal exposure to acetaminophen was not associated with ASC or ADHD symptoms. These results replicate previous work and support providing clear information to pregnant women and their partners about potential long-term risks of acetaminophen use.

早期对乙酰氨基酚暴露对自闭症谱系 (ASC) 和注意力缺陷/多动障碍 (ADHD) 的潜在病因学作用尚无定论。我们旨在通过对六个欧洲人口出生/儿童队列的合作研究来研究这种关联。该研究共纳入 73,881 对母子。产前和产后（最多 18 个月）对乙酰氨基酚暴露通过产妇问卷或访谈进行评估。使用经过验证的仪器在 4-12 岁时评估 ASC 和 ADHD 症状。使用每种仪器的推荐截止值将儿童分类为具有临界/临床症状。一个队列中也有医院诊断。分析针对儿童和母亲的特征以及对乙酰氨基酚的使用适应症进行了调整。使用随机效应荟萃分析将调整后的队列特异性效应估计值结合起来。对于 ASC，具有临界/临床症状的儿童比例介于 0.9% 和 12.9% 之间，对于 ADHD 介于 1.2% 和 12.2% 之间。结果表明，产前暴露于对乙酰氨基酚的儿童随后出现临界或临床 ASC（OR = 1.19, 95% CI 1.07-1.33）和 ADHD 症状（OR = 1.21, 95% CI 1.07-1.36）的可能性分别高出 19% 和 21%与未接触的儿童相比。男孩和女孩在产前暴露后出现 ASC 和 ADHD 症状的几率更高，尽管这些关联在男孩中略强。产后暴露于对乙酰氨基酚与 ASC 或 ADHD 症状无关。