{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:45:51Z","timestamp":1788417951579,"version":"build-2803163510"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006181","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado da Bahia","doi-asserted-by":"publisher","award":["7190\/2011"],"award-info":[{"award-number":["7190\/2011"]}],"id":[{"id":"10.13039\/501100006181","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006181","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado da Bahia","doi-asserted-by":"publisher","award":["APP0038\/2011"],"award-info":[{"award-number":["APP0038\/2011"]}],"id":[{"id":"10.13039\/501100006181","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006181","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado da Bahia","doi-asserted-by":"publisher","award":["BOL0401\/2019"],"award-info":[{"award-number":["BOL0401\/2019"]}],"id":[{"id":"10.13039\/501100006181","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["481509\/2012-7"],"award-info":[{"award-number":["481509\/2012-7"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Paracetamol is widely used to manage fever and pain during pregnancy worldwide. However, paracetamol may affect the pregnant woman and fetus, once this drug crosses the placental barrier after therapeutic doses and may impair fetal liver function, affecting fetus growth and development. Thus, this study aimed to investigate the association between paracetamol use during pregnancy and perinatal outcomes as preterm birth, low birth weight, and small for gestational age.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods and findings<\/jats:title><jats:p>Data from 760 pregnant women within the NISAMI Cohort between June 2012 and February 2014 were analyzed. Logistic regression was used to estimate the association among paracetamol use during pregnancy and preterm birth, low birth weight, and small for gestational age. Multivariate analyses were adjusted for socioeconomic, maternal, pregnancy, and newborn covariates. Around 14% of women were exposed to paracetamol during pregnancy. A decrease in paracetamol use throughout pregnancy was observed. Lower risk of low birth weight in infants born to women exposed to the drug (OR 0.21; IC 95% 0.01\u20130.99) was found. Paracetamol use during pregnancy was not statistically associated with preterm birth or small for gestational age.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Conclusions<\/jats:title><jats:p>The findings of this study do not suggest an increased risk of perinatal outcomes. However, it should not be assumed that paracetamol is a risk-free medication and its use must be rational.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0267270","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T17:29:16Z","timestamp":1650302956000},"page":"e0267270","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Association between paracetamol use during pregnancy and perinatal outcomes: Prospective NISAMI cohort"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9445-8842","authenticated-orcid":true,"given":"Caroline Tianeze","family":"de Castro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6128-1155","authenticated-orcid":true,"given":"Djanilson Barbosa","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"issue":"5","key":"pone.0267270.ref001","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s00228-011-1154-9","article-title":"Exposed or not exposed? Exploring exposure classification in studies using administrative data to investigate outcomes following medication use during pregnancy","volume":"68","author":"LE Grzeskowiak","year":"2012","journal-title":"Eur J Clin Pharmacol"},{"issue":"3","key":"pone.0267270.ref002","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1002\/ajmg.c.30313","article-title":"Evolving knowledge of the teratogenicity of medications in human pregnancy","volume":"157","author":"MP Adam","year":"2011","journal-title":"Am J Med Genet Part C Semin Med Genet"},{"issue":"9","key":"pone.0267270.ref003","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1002\/pds.2184","article-title":"Prescription drug use during pregnancy in developed countries: a systematic review","volume":"20","author":"JR Daw","year":"2011","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"1","key":"pone.0267270.ref004","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1111\/jmwh.12358","article-title":"Medication Safety During Pregnancy: Improving Evidence\u2010Based Practice","volume":"61","author":"SM Sinclair","year":"2016","journal-title":"J Midwifery Womens Health"},{"issue":"5","key":"pone.0267270.ref005","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.siny.2017.07.006","article-title":"Perinatal and neonatal use of paracetamol for pain relief","volume":"22","author":"K Allegaert","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"issue":"3","key":"pone.0267270.ref006","first-page":"196","article-title":"Consumption of paracetamol during pregnancy","volume":"93","author":"B Castillo Barrio","year":"2020","journal-title":"An Pediatr"},{"issue":"1","key":"pone.0267270.ref007","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s40264-018-0712-9","article-title":"POMME: The New Cohort to Evaluate Long-Term Effects After Prenatal Medicine Exposure","volume":"42","author":"J Benevent","year":"2019","journal-title":"Drug Saf"},{"key":"pone.0267270.ref008","article-title":"Use of stimulants, over\u2010the\u2010counter and prescription drugs among Danish pregnant women","author":"T Volqvartz","year":"2020","journal-title":"Basic Clin Pharmacol Toxicol"},{"issue":"3","key":"pone.0267270.ref009","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/ppe.12595","article-title":"Acetaminophen use in pregnancy: Examining prevalence, timing, and indication of use in a prospective birth cohort","volume":"34","author":"G Bandoli","year":"2020","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"5","key":"pone.0267270.ref010","doi-asserted-by":"crossref","first-page":"e20163840","DOI":"10.1542\/peds.2016-3840","article-title":"Prenatal Exposure to Acetaminophen and Risk of ADHD","volume":"140","author":"E Ystrom","year":"2017","journal-title":"Pediatrics"},{"issue":"2","key":"pone.0267270.ref011","doi-asserted-by":"crossref","DOI":"10.1590\/0102-311x00126215","article-title":"Utiliza\u00e7\u00e3o de medicamentos antes e durante a gesta\u00e7\u00e3o: preval\u00eancia e fatores associados","volume":"33","author":"DB Costa","year":"2017","journal-title":"Cad Saude Publica"},{"issue":"1","key":"pone.0267270.ref012","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12888-018-1942-1","article-title":"Is intrauterine exposure to acetaminophen associated with emotional and hyperactivity problems during childhood? Findings from the 2004 Pelotas birth cohort","volume":"18","author":"L Tovo-Rodrigues","year":"2018","journal-title":"BMC Psychiatry"},{"issue":"3","key":"pone.0267270.ref013","doi-asserted-by":"crossref","first-page":"989","DOI":"10.3390\/ijerph17030989","article-title":"Medication Use among Pregnant Women from the 2015 Pelotas (Brazil) Birth Cohort Study","volume":"17","author":"BH Lutz","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0267270.ref014","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1590\/S0100-72032008000100003","article-title":"Utiliza\u00e7\u00e3o de medicamentos durante a gravidez na cidade de Natal, Rio Grande do Norte, Brasil","volume":"30","author":"GCB Guerra","year":"2008","journal-title":"Rev Bras Ginecol e Obs"},{"issue":"3","key":"pone.0267270.ref015","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.ajog.2005.02.100","article-title":"Use of over-the-counter medications during pregnancy","volume":"193","author":"MM Werler","year":"2005","journal-title":"Am J Obstet Gynecol"},{"issue":"2","key":"pone.0267270.ref016","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2007.08.040","article-title":"Acetaminophen use during pregnancy: effects on risk for congenital abnormalities","volume":"198","author":"C Rebordosa","year":"2008","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"pone.0267270.ref017","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/AOG.0b013e3181c52616","article-title":"Acetaminophen use in pregnancy and risk of birth defects: Findings from the national birth defects prevention study","volume":"115","author":"ML Feldkamp","year":"2010","journal-title":"Obstet Gynecol"},{"issue":"4","key":"pone.0267270.ref018","first-page":"435","article-title":"A population-based case control study of congenital abnormalities and medication use during pregnancy using the Czech National Register of congenital abnormalities","volume":"6","author":"J Ma\u0161kov\u00e1","year":"2011","journal-title":"Cent Eur J Med"},{"issue":"3","key":"pone.0267270.ref019","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/ije\/dyp151","article-title":"Use of acetaminophen during pregnancy and risk of adverse pregnancy outcomes","volume":"38","author":"C Rebordosa","year":"2009","journal-title":"Int J Epidemiol"},{"issue":"7411","key":"pone.0267270.ref020","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1136\/bmj.327.7411.368","article-title":"Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population based cohort study","volume":"327","author":"D-K Li","year":"2003","journal-title":"BMJ"},{"issue":"7","key":"pone.0267270.ref021","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1038\/s41390-019-0726-8","article-title":"Association between maternal acetaminophen use and adverse birth outcomes in a pregnancy and birth cohort","volume":"87","author":"J Arneja","year":"2020","journal-title":"Pediatr Res"},{"issue":"2","key":"pone.0267270.ref022","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1111\/j.1365-3016.2005.00631.x","article-title":"Short-term paracetamol therapy during pregnancy and a lower rate of preterm birth","volume":"19","author":"AE Czeizel","year":"2005","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"7","key":"pone.0267270.ref023","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1055\/s-2007-993879","article-title":"Fetal growth and adverse birth outcomes in women receiving prescriptions for acetaminophen during pregnancy","volume":"16","author":"AM Thulstrup","year":"1999","journal-title":"EuroMap Study Group. Am J Perinatol"},{"issue":"6","key":"pone.0267270.ref024","first-page":"541","article-title":"Transplacental Passage of Acetaminophen in Term Pregnancy","volume":"34","author":"JF Nitsche","year":"2017","journal-title":"Am J Perinatol"},{"key":"pone.0267270.ref025","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica. Censo Demogr\u00e1fico\u20142010: Caracter\u00edsticas da popula\u00e7\u00e3o e dos domic\u00edlios [Internet]. 2011. Available from: http:\/\/cidades.ibge.gov.br\/painel\/painel.php?lang=&codmun=292870&search=bahia%7Csantoantonio-de-jesus%7Cinfograficos:-dados-gerais-do-municipio."},{"key":"pone.0267270.ref026","unstructured":"DATASUS. Departamento de Inform\u00e1tica do SUS, DATASUS. Informa\u00e7\u00f5es de Sa\u00fade, Estat\u00edsticas Vitais: banco de dados [Internet]. Nov 5, 2017. Available from: http:\/\/datasus.saude.gov.br\/index.php?option=com_content&view=article&id=152."},{"key":"pone.0267270.ref027","author":"AA Fagundes","year":"2004","journal-title":"Vigil\u00e2ncia alimentar e nutricional\u2014Sisvan\u202f: orienta\u00e7\u00f5es b\u00e1sicas para a coleta, processamento, an\u00e1lise de dados e informa\u00e7\u00e3o em servi\u00e7os de sa\u00fade. Bras\u00edlia"},{"issue":"49","key":"pone.0267270.ref028","doi-asserted-by":"crossref","first-page":"6047","DOI":"10.1016\/j.vaccine.2016.03.045","article-title":"Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data","volume":"34","author":"J-A Quinn","year":"2016","journal-title":"Vaccine"},{"key":"pone.0267270.ref029","first-page":"1","volume-title":"Global Nutrition Targets 2025: Low birth weight policy brief","author":"World Health Organization","year":"2014"},{"issue":"48 Pt A","key":"pone.0267270.ref030","doi-asserted-by":"crossref","first-page":"6518","DOI":"10.1016\/j.vaccine.2017.01.040","article-title":"Small for gestational age: Case definition & guidelines for data collection, analysis, and presentation of maternal immunisation safety data","volume":"35","author":"EP Schlaudecker","year":"2017","journal-title":"Vaccine"},{"issue":"10","key":"pone.0267270.ref031","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1002\/pds.4277","article-title":"Metamizole use during first trimester-A prospective observational cohort study on pregnancy outcome","volume":"26","author":"K Dathe","year":"2017","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"2","key":"pone.0267270.ref032","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/CJ9.0000000000000111","article-title":"Is it time to restrict the clinical use of dipyrone?","volume":"47","author":"OG G\u00f3mez-Duarte","year":"2019","journal-title":"Colomb J Anesthesiol"},{"issue":"8","key":"pone.0267270.ref033","doi-asserted-by":"crossref","first-page":"e0135775","DOI":"10.1371\/journal.pone.0135775","article-title":"Prenatal Paracetamol Exposure and Wheezing in Childhood: Causation or Confounding?","volume":"10","author":"E Migliore","year":"2015","journal-title":"PLoS One"},{"issue":"5","key":"pone.0267270.ref034","doi-asserted-by":"crossref","first-page":"371","DOI":"10.3109\/14767050903334877","article-title":"Use of acetaminophen during pregnancy and risk of preeclampsia, hypertensive and vascular disorders: A birth cohort study","volume":"23","author":"C Rebordosa","year":"2010","journal-title":"J Matern Neonatal Med"},{"issue":"4","key":"pone.0267270.ref035","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1016\/0002-9378(93)90362-M","article-title":"The effect of acetaminophen on prostacyclin production in pregnant women","volume":"168","author":"WF O\u2019Brien","year":"1993","journal-title":"Am J Obstet Gynecol"},{"issue":"5","key":"pone.0267270.ref036","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.apjr.2016.07.009","article-title":"Maternal and obstetric risk factors associated with preterm delivery at a referral hospital in northern-eastern Tanzania","volume":"5","author":"TB Temu","year":"2016","journal-title":"Asian Pacific J Reprod"},{"issue":"1","key":"pone.0267270.ref037","first-page":"47","article-title":"Prevalence and risk factors associated with preterm birth in Ardabil","volume":"12","author":"R Alijahan","year":"2014","journal-title":"Iran. Iran J Reprod Med"},{"issue":"1","key":"pone.0267270.ref038","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-020-03328-6","article-title":"Maternal demographic and antenatal factors, low birth weight and preterm birth: findings from the mother and child in the environment (MACE) birth cohort, Durban, South Africa","volume":"20","author":"PM Jeena","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pone.0267270.ref039","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.pedneo.2013.05.005","article-title":"Parental smoking during pregnancy and its association with low birth weight, small for gestational age, and preterm birth offspring: A birth cohort study","volume":"55","author":"TJ Ko","year":"2014","journal-title":"Pediatr Neonatol"},{"issue":"1","key":"pone.0267270.ref040","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-020-02903-1","article-title":"The epidemiologic characteristics and associated risk factors of preterm birth from 2004 to 2013 in Taiwan","volume":"20","author":"YK Chang","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"4","key":"pone.0267270.ref041","doi-asserted-by":"crossref","first-page":"e009986","DOI":"10.1136\/bmjopen-2015-009986","article-title":"Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis","volume":"6","author":"JKL Gunn","year":"2016","journal-title":"BMJ Open"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0267270","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T04:06:09Z","timestamp":1700453169000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0267270"}},"subtitle":[],"editor":[{"given":"Linglin","family":"Xie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,18]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0267270","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,18]]}}}