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By Faith Nyasuguta 

A multinational group of 13 scientists has called on the healthcare community to carefully consider the use of paracetamol/acetaminophen (APAP) during pregnancy until the painkiller is thoroughly probed for any potential impact on fetal development in the womb.

In a statement published on Thursday in the journal Nature Reviews Endocrinology, a ballooning body of research reveals that “prenatal exposure to APAP might alter fetal development, which could increase the risks of some neurodevelopmental, reproductive and urogenital disorders.”

The statement by the scientists is not on health guidance, but it calls on health care providers and regulators to act.

An expectant woman /Courtesy/

“The authors are not recommending anything counter to what is already done by obstetrician-gynecologists when prescribing acetaminophen for a given clinical condition,” Dr. Christopher Zahn, the vice president of practice activities for the American College of Obstetricians and Gynecologists who was not involved in the statement said.

Adding, “However, as always, any medication taken during pregnancy should be used only as needed, in moderation, and after the pregnant patient has consulted with their doctor,” he added.

The consensus statement was signed by 91 scientists from across the globe and it called for pregnant women to be warned to “forgo use” of paracetamol or acetaminophen during pregnancy “unless its use is medically indicated.”

Even with approval from a doctor, the statement called on women to “minimize exposure by using the lowest effective dose for the shortest possible time.”

“There are good medical reasons for pregnant women to use APAP, after consulting physicians or pharmacists, and that is for fever and severe pain,” David Kristensen, an associate professor of cell biology and physiology at the University of Copenhagen and one of the 13 co-authors of the statement said.

The statement noted that high fever is a renowned risk for multiple fetal disorders, “including neural tube defects and later life cardiovascular disorders.” 

Documented studies reveal that only a third of expectant women use paracetamol to counter fever. 

Instead, “headache, muscle pain, back pain, and infection” were revealed as the most common reasons for use.

“Data suggests more than 50% of women worldwide are using APAP during their pregnancies,” Kristensen said.

 “Many of these women do not consider APAP as a true medication that can have potential side effects.

“It is those women who do not consider it as a true medication that we are trying to reach and want them to reflect a moment on their use,” he added.

Paracetamol /Courtesy/

For years, paracetamol has been the only pain reliever generally considered safe for use throughout pregnancy. This means that mothers-to-be will be left with few medical options if it is shown to be harmful to a fetus.

“Ibuprofen has already been linked with birth defects and damage to the baby’s heart and blood vessels,” while high doses of aspirin have been tied to “bleeding in the brain and congenital defects,” pediatrician Leonardo Trasande, the director of environmental pediatrics at NYU Langone Health, who was not involved with the creation of the statement also said.


“Research on acetaminophen shows this is an emerging field of concern,” Trasande said. 

“I’m always going to say that further research is needed to understand the mechanisms and to control for other exposures. But the fact is there is substantial evidence to suggest that at the very least, this is a hazard for the fetus.”

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Faith Nyasuguta

1 Comment

    This is very informative.

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