産前のアセトアミノフェン使用と発達障害のリスクを関連づけ(Prenatal Acetaminophen Use May Be Linked to Increased Risk of Autism and ADHD)

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2025-08-13 マウントサイナイ医療システム(MSHS)

Mount Sinaiの研究は、妊娠中のアセトアミノフェン使用と子どもの自閉症スペクトラム障害(ASD)および注意欠如・多動症(ADHD)リスク増加との関連を、Navigation Guide Systematic Review手法で評価した。質の高い研究ほど関連を支持する傾向が強く、胎盤通過後に酸化ストレスやホルモンバランス変化、エピジェネティック変化を引き起こす可能性が示唆された。ただし因果関係は未証明であり、研究チームは妊婦に対し「全く使わない」のではなく、医師管理下で短期間に限って使用し、非薬物的対処法も検討するよう推奨。未治療の発熱や痛みも胎児に悪影響を与える可能性があるため、医療従事者との相談が重要とした。

<関連情報>

アセトアミノフェンの使用と神経発達障害に関する証拠の評価を、ナビゲーション・ガイド手法を用いて行う Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology

Diddier Prada,Beate Ritz,Ann Z. Bauer & Andrea A. Baccarelli
Environmental Health  Published:14 August 2025
DOI:https://doi.org/10.1186/s12940-025-01208-0

産前のアセトアミノフェン使用と発達障害のリスクを関連づけ(Prenatal Acetaminophen Use May Be Linked to Increased Risk of Autism and ADHD)

Abstract

Background

Acetaminophen is the most commonly used over-the-counter pain and fever medication taken during pregnancy, with > 50% of pregnant women using acetaminophen worldwide. Numerous well-designed studies have indicated that pregnant mothers exposed to acetaminophen have children diagnosed with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), at higher rates than children of pregnant mothers who were not exposed to acetaminophen.

Methods

We applied the Navigation Guide methodology to the scientific literature to comprehensively and objectively examine the association between prenatal acetaminophen exposure and NDDs and related symptomology in offspring. We conducted a systematic PubMed search through February 25, 2025, using predefined inclusion criteria and rated studies based on risk of bias and strength of evidence. Due to substantial heterogeneity, we opted for a qualitative synthesis, consistent with the Navigation Guide’s focus on environmental health evidence.

Results

We identified 46 studies for inclusion in our analysis. Of these, 27 studies reported positive associations (significant links to NDDs), 9 showed null associations (no significant link), and 4 indicated negative associations (protective effects). Higher-quality studies were more likely to show positive associations. Overall, the majority of the studies reported positive associations of prenatal acetaminophen use with ADHD, ASD, or NDDs in offspring, with risk-of-bias and strength-of-evidence ratings informing the overall synthesis.

Conclusions

Our analyses using the Navigation Guide thus support evidence consistent with an association between acetaminophen exposure during pregnancy and increased incidence of NDDs. Appropriate and immediate steps should be taken to advise pregnant women to limit acetaminophen consumption to protect their offspring’s neurodevelopment.

医療・健康
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