Pregnant women should reduce their consumption of paracetamol and warnings should be added to packaging, an international coalition of experts said today.
They said there was growing evidence that paracetamol could affect a baby’s development in the womb and increase the risk of ADHD (attention deficit hyperactivity disorder) and autism.
They added that it should only be taken at the “lowest effective dose for the shortest possible time” and that pregnant women should avoid “indiscriminate” use.
The current NHS advice is that pregnant and breastfeeding women can take paracetamol safely. US and EU drug regulators say the drug poses minimal risk when taken correctly during pregnancy.
It is believed that more than half of pregnant women worldwide take it for fever and pain relief, as alternatives such as ibuprofen are not recommended in the later stages of pregnancy.
Today, more than 90 experts, including the United States, Scotland, Denmark, Sweden and France, issued a “consensus statement” calling for caution in the use of paracetamol during pregnancy after reviewing 25 years of research on the subject.
They also said there should be targeted research on the apparent increased risk of “neurodevelopmental, reproductive and urogenital” disorders.
They said there were “worrying increases” in the number of children with cognitive, learning and / or behavioral problems.
Some research has also suggested an increased risk of undescended testes in boys and precocious puberty in girls.
However, it is also known that an untreated fever in a pregnant woman carries a slight risk of neural and heart problems, and paracetamol helps reduce this.
Andrew Shennan, professor of obstetrics at King’s College London, who was not involved in the research, said it was a “balanced view of the potential risk / benefit of paracetamol during pregnancy.”
Professor Shennan said, “They point out that treating pain and fever may reduce the chances of pregnancy, and alternatives to paracetamol have evidence of harm. The evidence that paracetamol is harmful is not strong, but observations in humans regarding possible developmental problems are supported by animal studies.
“It is always important to take medication during pregnancy with the advice of a specialist. A good principle is to only use drugs that have been proven to be effective and safe. Paracetamol is one of those drugs that can be used safely.
“The baby is fully formed at 10 weeks pregnant and it is unlikely that any drug will cause significant damage to the developing fetus after this stage.
“Careful monitoring and more research should continue, but paracetamol can be used to treat pain and fever during pregnancy. “
Dr Sarah Stock, reader and consultant in maternal and fetal medicine at the Usher Institute at the University of Edinburgh, said: “This document does not change the recommendations for the use of paracetamol during pregnancy.
“The team did a good job of putting together the existing evidence, but unfortunately much of this evidence is not strong enough to draw conclusions that the use of paracetamol during pregnancy, especially occasional use , causes developmental problems in humans.
“Paracetamol is effective in reducing pain and fever, and therefore continues to be an important drug that pregnant women should use when needed.
“Of course, pregnant or not, no one should take medication unnecessarily, for longer than necessary, or at a higher dose than necessary.
“There is no new data in this publication – it is a summary of previous studies. The authors rightly push for more good quality research, because based on current evidence d Studies published previously, it is impossible to determine whether it is the conditions that cause people to take paracetamol in high doses for long periods of time, or paracetamol itself, that could be related to developmental problems.