Paracetamol risk in pregnancy

Pregnancy comes with aches and pains and heightened anxiety about what we put into the body.

A new article published in Nature Reviews Endocrinology has urged caution around taking paracetamol during pregnancy. The paper is a “consensus statement” that brings together analysis by a panel of experts who looked at the evidence from human and animal studies of paracetamol use in pregnancy.

According to the authors, paracetamol use during pregnancy may alter fetal development, with long-lasting effects on child health. The authors call for improved education for healthcare professionals and patients, less paracetamol use during pregnancy and further research.

Alert but not alarmed

At first glance, calls to minimise paracetamol use during pregnancy are alarming. For those who have taken paracetamol (commonly marketed in Australia as Panadol, Herron Paracetamol, Panamax, Chemist Own or Dymadon) during pregnancy, this could cause anxiety.

This new consensus statement calls for caution, but not a concern. The proposed recommendations are broadly consistent with current advice provided to pregnant women in Australia.

With any medication in pregnancy, there needs to be a careful balance between treating a maternal condition and protecting the unborn. A trusted health care provider can help reach an informed decision. Paracetamol is no different.

What are the concerns?

Worldwide, more than 50% of pregnant women use paracetamol to treat pain and/or fever. Paracetamol is the active ingredient in hundreds of prescription and non-prescription products. It has been widely regarded for many years as safe to use during pregnancy.

Some, but not all, observational studies in humans suggest paracetamol use during pregnancy may alter fetal development. The new statement notes that paracetamol has an increased risk of certain neurodevelopmental, reproductive and urogenital disorders.

But these studies have limitations. Researchers have found it hard to distinguish the effects of paracetamol from the effects of underlying illness. And there are potential inaccuracies in recording the amount and timing of paracetamol use across an entire pregnancy as are highlighted in the accompanying editorial.

Possible risks of paracetamol use in pregnancy are supported by a number of animal studies, the authors say. For this reason, caution regarding paracetamol use has been advised until a definitive link can be proven or disproven.

It’s worth noting the available evidence suggests any possible harms of paracetamol are likely to be dose-related. As highlighted by the review article, most increased risks have been linked with use in pregnancy for more than two or four weeks. Current evidence suggests limited risks to unborn babies when paracetamol is taken short-term.

Timing is also important. Taking paracetamol during the first trimester has been linked to an increased risk of reproductive and urogenital disorders. Neurodevelopmental disorders have been linked to use in the second or third trimester.

Source: https://theconversation.com/take-care-with-paracetamol-when-pregnant-but-dont-let-pain-or-fever-go-unchecked-168747