A team of international scientists are cautioning against the use of paracetamol (acetaminophen) in pregnant women, citing adverse effects on fetal development.
Paracetamol, also known as acetaminophen, is present in more than 600 prescription and non-prescription medicines. Thus, making it one of the most commonly used medications globally. Doctors often prescribe the drug for relieving pain and fever in both children and adults. Moreover, regulatory authorities such as FDA and EMA both deem the drug safe for use in pregnancy. More than 50% of pregnant women worldwide use paracetamol for pain and fever. However, as the rates of neurological, urogenital, and reproductive disorders increase, experts worry environmental exposure during fetal life might be to blame.
Due to milder side effects, paracetamol (APAP) is often preferred over Non-Steroidal Anti-Inflammatory drugs (NSAIDs). However, the drug does not come without complications. Overdose can often cause tachycardia, low blood pressure, and allergic reactions. Moreover, chronic use of the drug can cause liver and kidney damage in adults and children.
The FDA has given the drug a ‘B’ rating for pregnant women. Category B drugs are those that have failed to demonstrate any risks to the fetus in animal studies. Additionally, no adequate and well-controlled studies have been conducted for the drug, in pregnant women.
Experts Urge Caution
In a new consensus statement, written by 13 international scientists, experts suggest that pregnant women only take paracetamol if medically necessary. Moreover, after consultation with their doctor. The group of experts believe that the use of paracetamol should first be thoroughly investigated for its effects on fetal development. They based their statement on data from 29; 26 of which found evidence of birth defects.
Since fever can have severe outcomes on fetal development, treating it is highly essential during pregnancy. However, not all pregnant women use paracetamol to treat fever. Majority report using it for headaches, back and muscle pain, and infection; staying unaware of the drug’s adverse effects. Therefore, scientists urge caution in hopes to minimize exposure to the growing fetus.
However, the team of scientists do not advocate for a ban on the drug. They believe their suggestion is no different than what is obstetricians and gynaecologists currently recommend. Instead, they suggest that health professionals practice caution when prescribing paracetamol to pregnant women. Moreover, they advocate for a lower dose and shorter duration of use in pregnant women.
Ann Z. Bauer et al, Paracetamol use during pregnancy—a call for precautionary action, Nature Reviews Endocrinology (2021). DOI: 10.1038/s41574-021-00553-7