Pregnant women should NOT always take paracetamol, doctors say

Pregnant women should only take paracetamol when instructed by a doctor, scientists ruled today.

Experts fear that the cheap pain reliever may hinder a baby’s development in the womb.

Dozens of studies have linked it to Attention deficit hyperactivity disorder (ADHD), autism, language delay in girls, and decreased IQ.

Danish researchers reviewing the evidence argued that there was “an increasing amount of research” on fears that paracetamol may interfere with fetal development.

In a call to action, they insisted that expectant mothers only get “the lowest effective dose for the shortest time possible.”

More studies are needed to thoroughly examine exactly how the drug, known as acetaminophen in the United States, can affect babies in the womb.

But other scientists today dismissed those claims, saying the collection of papers reviewed was “not strong enough to draw any conclusions.”

And one said that pregnant mothers’ anxiety about the unborn child was “often in itself unnecessary and had obvious negative consequences.”

The NHS says paracetamol is safe during pregnancy, describing it as the “first choice” pain reliever for expectant mothers.

About half of pregnant women report taking paracetamol during pregnancy, and the figure rises to 65% in the United States.

Health chiefs say only certain people need to take “extra care,” such as patients with liver or kidney problems and those taking epilepsy medication.

Experts said that a “growing body of research” suggests that if paracetamol is taken during pregnancy, it affects the development of the fetus, which could increase the risk of brain, reproductive and urogenital disorders in the child once. not. These include an increased incidence of ADHD and autism, as well as the early onset of puberty.

Animal studies have shown that paracetamol can cause reproductive orders in men, such as abnormalities in testicular and sperm function, and in women, such as disturbance of ovarian development, resulting in reduced the number of eggs, resulting in reduced fertility.

The warning about paracetamol during pregnancy was published today in the journal Nature Endocrinology Reviews.

It was supported by a group of 91 international experts.

The article claimed that an “increasing amount of research” linked paracetamol to certain neurodevelopmental, reproductive and urogenital disorders.

Dr David Kristensen and experts from the University of Copenhagen reviewed human and animal studies that have looked at the use of paracetamol during pregnancy.

The research projects were all published between 1995 and 2020.

Writing in the journal, they claimed studies had linked the widespread use of paracetamol to a “worrying increase” in the number of children with cognitive, learning or behavioral disabilities.

Research has also shown that the pain reliever is linked to reproductive and urogenital disorders, such as cryptorchidism (undescended testes) – hypospadias (when the opening to the urethra is not located at the end of the penis) and testicular cancer.

Rates of precocious puberty, decreased sperm count and decreased fertility have also been linked to the pain reliever, they said.

And exposure to paracetamol before birth is also associated with girls entering puberty earlier.

Meanwhile, animal studies have shown that the drug can also cause reproductive orders in men, such as abnormalities in testicular and sperm function.

Animal studies have also linked paracetamol during pregnancy with disruption of ovarian development in women, resulting in reduced egg count, resulting in reduced fertility.

Other effects in women that have been recorded in animal studies include impaired brain function and behavior.

And the negative effects of a mother taking paracetamol during pregnancy increased if the drug was taken in higher doses and for longer periods of time, the scientists said.

Therefore, pregnant women should be instructed during pregnancy on how to limit its use and dosage, according to their report.

They said pregnant women should be advised to “give up paracetamol unless its use is medically indicated”; consult a doctor or pharmacist if they are unsure whether use is indicated and before long-term use; and minimize exposure by using the lowest effective dose for the shortest possible time. ‘

The doctors also called on the European Medicines Agency (EMA) and the United States Food and Drug Administration (FDA) to “review all available data” so their advice is up to date.

The FDA and EMA said the studies showed no risk of birth defects from paracetamol.

Dr Sarah Stock, an expert in fetal medicine at the University of Edinburgh, said: “This document does not change the recommendations on the use of paracetamol during pregnancy.”

She said the team had “done a good job in putting together the existing evidence.”

But Dr Stock added: “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 the patient. man.

“Paracetamol is effective in reducing pain and fever and therefore continues to be an important medicine 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.”

Professor Stephen Evans, pharmacoepidemiology expert at the London School of Hygiene and Tropical Medicine, said: “Avoidance of unnecessary medication must be encouraged at all times, and most pregnant women are aware of this.

“At the same time, creating anxiety about their unborn child is often in itself unnecessary and has obvious negative consequences.

“This document and the consensus statement could be used to arouse anxiety, almost certainly unnecessarily.”

Larger studies tend to find “no adverse effects” on a child from their mother taking paracetamol and those which find some links are inconsistent, so “their conclusions may be due to chance or bias,” he said. he declared.

And there is no “obvious drug” that could be suggested as an alternative to paracetamol, so the report is “not very helpful.”

Professor Evans added: “It might be reasonable to suggest that regulators reconsider the issues, but that’s not a message to current or potential pregnant mothers.”