Use of acetaminophen during pregnancy and risk of preeclampsia, hypertensive and vascular disorders: a birth cohort study.
OBJECTIVE
To examine whether pregnant women who used acetaminophen, a prostaglandinG2 synthase inhibitor, had an increased risk of preeclampsia, gestational hypertension, thromboembolic complications, or abruptio placentae.


METHODS
We selected 63,833 women participating in the Danish National Birth Cohort who gave birth to a live born singleton and had information on acetaminophen use during pregnancy reported by three interviews. Through linkage to the National Hospital Discharge Registry we obtained data from hospital diagnose of the outcomes we study.


RESULTS
Women who used acetaminophen during the third trimester of pregnancy had an increased risk of preeclampsia (adjusted relative risk RR = 1.40, 95% CI: 1.24-1.58). The risk was higher among women who had early preeclampsia (before the 32nd gestational week) (RR = 1.47, 95% CI: 1.12-1.93), severe preeclampsia (RR = 1.51, 95% CI: 1.15-2.00), or chronic hypertension (RR = 1.44, 95% CI: 1.13-1.83). Second and third trimester use was associated with an increased risk of pulmonary embolisms (RR = 3.02, 1.28-7.15) and deep vein thrombosis (RR = 2.15, 1.06-4.37), respectively.


CONCLUSIONS
Acetaminophen use during pregnancy is associated with an increased risk of diseases in which a reduction of prostacyclin during pregnancy has been postulated to play a role, including preeclampsia and thromboembolic diseases.
Rebordosa
Cristina
C
Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain. crebordosa@creal.cat
Zelop
Carolyn M
CM
Kogevinas
Manolis
M
Sørensen
Henrik T
HT
Olsen
Jørn
J
D000082:Acetaminophen / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000465:Algorithms; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000209:etiology*; D007231:Infant, Newborn; D036801:Parturition; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third / Q000187:drug effects; D012306:Risk; D055815:Young Adult
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen