Associations between cord blood acetaminophen biomarkers and childhood asthma with and without allergic comorbidities

Yijun Li; Xiumei Hong; Aruna Chandran; Corinne A Keet; Clary B Clish; Liming Liang; Lisa P Jacobson; Xiaobin Wang; Christine Ladd-Acosta

doi:10.1016/j.anai.2024.03.001

Associations between cord blood acetaminophen biomarkers and childhood asthma with and without allergic comorbidities

Ann Allergy Asthma Immunol. 2024 Mar 12:S1081-1206(24)00143-1. doi: 10.1016/j.anai.2024.03.001. Online ahead of print.

Authors

Yijun Li¹, Xiumei Hong², Aruna Chandran³, Corinne A Keet⁴, Clary B Clish⁵, Liming Liang⁶, Lisa P Jacobson³, Xiaobin Wang⁷, Christine Ladd-Acosta⁸

Affiliations

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
² Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins Bloomberg School of Public Health, Baltimore, Massachusetts.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
⁴ Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
⁵ Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, Massachusetts.
⁶ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
⁷ Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins Bloomberg School of Public Health, Baltimore, Massachusetts; Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
⁸ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: claddac1@jh.edu.

PMID: 38484838
DOI: 10.1016/j.anai.2024.03.001

Abstract

Background: Previous studies have linked prenatal acetaminophen use to increased asthma risk in children. However, none have explored this association while differentiating between asthma cases with and without other allergic conditions or by employing objective biomarkers to assess acetaminophen exposure.

Objective: To evaluate whether the detection of acetaminophen biomarkers in cord blood is associated with the subgroups of asthma both with and without allergic comorbidities in children.

Methods: Acetaminophen biomarkers, including unchanged acetaminophen and acetaminophen glucuronide, were measured in neonatal cord blood samples from the Boston Birth Cohort. Asthma subgroups were defined on the basis of physician diagnoses of asthma and other allergic conditions (atopic dermatitis and allergic rhinitis). Multinomial regressions were used to evaluate the associations between acetaminophen biomarkers and asthma subgroups, adjusting for multiple confounders, including potential indications for maternal acetaminophen use such as maternal fever.

Results: The study included 142 children with asthma and at least 1 other allergic condition, 55 children with asthma but no other allergic condition, and 613 children free of asthma. Detection of acetaminophen in cord blood, reflecting maternal exposure to acetaminophen shortly before delivery, was associated with 3.73 times the odds of developing asthma without allergic comorbidities (95% CI: 1.79-7.80, P = .0004). In contrast, the detection of acetaminophen in cord blood was not associated with an elevated risk of asthma with allergic comorbidities. Analysis of acetaminophen glucuronide yielded consistent results.

Conclusion: In a prospective birth cohort, cord blood acetaminophen biomarkers were associated with an increased risk of childhood asthma without allergic comorbidities, but were not associated with childhood asthma with allergic comorbidities.

Abstract

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