Use of paracetamol during pregnancy requires more caution, scientists warn

If you are pregnant and in pain, there is not really many options. Aspirin is excluded, as is ibuprofen – and don’t even think about picking up opioids. In fact, one of the only things you can count on to help you deal with the pains associated with growing a whole new human in your body is paracetamol, or paracetamol.

It has long been the first port of call for pregnancy twinges in United States, Europe, and Australia – almost two thirds of pregnant women reported reaching Tylenol at some point during the construction of the nine month old baby. However, according to a new consensus statement published in Nature Endocrinology Reviews, we may need more caution to reach this so called “safe” pain reliever.

“We reviewed the research on the use of acetaminophen during pregnancy from 1995 to 2020 and found a growing body of evidence to suggest that the drug may impair fetal development, increasing the risk of improper development of reproductive organs and neurological disorders, mainly attention deficit hyperactivity disorder (ADHD) and associated behavioral abnormalities, but also autism spectrum disorders (ASD), language delays, decreased IQ and conduct disorders ”, lead author Ann Bauer explained in a press release.

“Acetaminophen is one of the most common drugs used during pregnancy and its use is increasing. Research suggests that up to 65% of American women and 50% of women worldwide use acetaminophen, ”she continued. “Because use is so common, if acetaminophen is responsible for even a small increase in individual risk, it could contribute significantly to these disorders in the general population.”

Pregnancy can be such a stressful time as it is, so it’s important to note that the authors are not calling for a ban on acetaminophen during pregnancy, only for greater caution in its use. Indeed, as an accompaniment editorial Note, the study recommendations “may not differ significantly from current advice in some countries”: use the drug only when necessary, use the lowest possible dose for the shortest possible time and consult your doctor. doctor, midwife or obstetrician / gynecologist if you need advice.

“[The] The consensus statement is a balanced view of the potential risk / benefit of paracetamol during pregnancy ”, commented Andrew Shennan, Professor of Obstetrics at King’s College London. “They point out that treating pain and fever could 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.

While the potential effects of acetaminophen may seem frightening, the editorial notes that “there appears to be a dose-response relationship” at play. In other words: the longer you use the drug – especially if you use it for two weeks or more – the riskier it becomes.

The authors also suggest that “the moment of [acetaminophen] the use in particular gestation windows could also be of crucial importance. Shennan, who was not in the study, agrees that “at 10 weeks pregnant and that a drug is unlikely to cause significant damage to the developing fetus.”

However, the authors write, more research and greater awareness of these issues is critical, as pregnant people – and even healthcare professionals – often feel that acetaminophen is essentially “safe.”

“We urge medical and industry authorities to review research and publish guidelines specific to acetaminophen,” Bauer concluded. “While these guidelines are not radically different from their current guidelines, we believe that acetaminophen specific guidelines are warranted, as knowledge of this research among physicians and patients is limited and the perception of total safety is incorrect. of this drug persists. “