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Am J Epidemiol. 2018 Sep 7. doi: 10.1093/aje/kwy193. [Epub ahead of print]

Acetaminophen (Paracetamol) Exposure During Pregnancy and Pubertal Development in Boys and Girls From a Nationwide Puberty Cohort.

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Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus C, Denmark.
Fielding School of Public Health, Department of Epidemiology, University of California Los Angeles.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
Department of Public Health, Section for Biostatistics, Aarhus University, Aarhus C, Denmark.
Department of Urology, Section for Paediatric Urology, Aarhus University Hospital, Aarhus N, Denmark.


This study explored the association between exposure to acetaminophen during pregnancy and pubertal development using data from 15,822 boys and girls in the longitudinal Puberty Cohort, nested within The Danish National Birth Cohort. Use of acetaminophen was reported three times during pregnancy and six months postpartum. In total, 54% of mothers indicated use at least once during pregnancy. Between 2012 and 2017, sons and daughters provided information on a wide range of pubertal milestones, including Tanner stages, axillary hair growth and age at menarche or voice break and first ejaculation, every six months from 11 years of age until full sexual maturation. Data were analyzed by a regression model for interval-censored data, providing adjusted mean monthly differences in age at attaining the pubertal milestones according to intrauterine cumulative (weeks) and trimester specific acetaminophen exposure. Our results suggested a tendency towards slightly earlier attainment of almost all studied markers of female pubertal development with increasing number of weeks of exposure (i.e., about 1.5-3 months earlier age at pubic hair, axillary hair and acne development comparing unexposed with those prenatally exposed for more than 12 weeks). Male pubertal development had no strong association with acetaminophen exposure.


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