Recently, I’ve received several questions about the use of paracetamol during pregnancy.

Paracetamol (also known as acetaminophen) is typically prescribed during different stages of pregnancy in the following cases (NHS UK, 2015):

– mild to moderate pain
– high body temperature (fever)

Paracetamol does not have anti-inflammatory properties!

What Does the Research Say?

Research on ADHD-like behavior (UKTIS, 2017):

• A small study of 4-year-olds showed no link between in-utero paracetamol exposure and attention problems.
• A larger study of 3-year-olds showed a possible link between in-utero paracetamol exposure for more than 28 days and higher levels of activity.
• A larger study of children assessed at five and then again at seven years suggested that children exposed to paracetamol in utero had a slightly increased likelihood of developing ADHD-like behavior.
• A study of five-year-old children exposed to paracetamol in utero did not show that these children developed ADHD compared to those not exposed.
• A larger study of seven-year-olds showed that children exposed to paracetamol in utero were more likely to develop hyperactive behavior, but further data analysis suggested that factors from the home environment immediately after birth may have influenced this, subjecting the study to numerous criticisms.

A Norwegian study of approximately 50,000 children highlighted that there could be a possible link between regular long-term use of paracetamol during pregnancy (long-term—in this case defined as more than one month during pregnancy) and developmental problems, such as difficulties with communication and behavior (Brandlistuen, Ystrom, Nulman, Koren, Nordeng, 2013).

Of the six studies examined, three found a link between taking paracetamol during pregnancy and the occurrence of asthma-like symptoms—wheezing—in the child during early childhood. Three studies did not find this link. The main criticism of these studies was that they focused on the occurrence of wheezing, which does not necessarily mean the development of asthma, and that some other factor may have influenced the appearance of these symptoms (NHS UK, 2011).

The studies mentioned above do not provide convincing scientific evidence that taking paracetamol during pregnancy causes learning and behavioral problems in children. Many doctors and scientists who are recognized experts in this field have expressed concerns about the quality of some of these studies, including the methods of collecting and analyzing information and the fact that other factors (for example, the mother’s illness for which she used paracetamol for treatment) could have caused the effects in children exposed to paracetamol in utero. The media often reports that these studies have shown that paracetamol use during pregnancy causes behavioral problems in children, and recently some studies in rats and mice (not humans) suggest a link between in-utero paracetamol exposure and later infertility in offspring. Many experts agree that the evidence is not strong enough to draw such conclusions in humans and that much more research is needed before we can conclude that differences in learning and behavior, as well as other consequences identified in some of these studies, are related to paracetamol use during pregnancy.

The current NHS UK advice is that paracetamol remains safe for use during pregnancy at the recommended adult dose (up to 1 g every 4-6 hours with a maximum of 4 g in a 24-hour period) (NHS UK, 2015). Before taking any medication during pregnancy, consult with your chosen doctor or gynecologist (NHS, 2018).

If you cannot manage fever or pain with the recommended dose of paracetamol, consult with your midwife or doctor.

For mild headaches that occur during pregnancy, before taking painkillers, I recommend rest, adequate fluid intake, relaxation, a regular balanced diet, tea, acupuncture, acupressure, aromatherapy, and other natural ways of relaxing and relieving discomfort.

SOURCES:

https://www.nhs.uk/chq/Pages/2397.aspx?CategoryID=54

https://www.ncbi.nlm.nih.gov/pubmed/24163279

http://www.madeformums.com/pregnancy/paracetamol-in-pregnancy—is-it-safe/31070.html

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2543281

https://www.nhs.uk/news/pregnancy-and-child/paracetamol-in-pregnancy-linked-to-asthma/

http://www.ffa.uni-lj.si/fileadmin/homedirs/11/Predmeti/Klinicna_farmacija/Bolecina/Dolinar_Paracetamol.pdf

https://www.nhs.uk/common-health-questions/pregnancy/can-i-take-paracetamol-when-i-am-pregnant/

photo