One of the few painkillers that are generally regarded as safe to take while pregnant is acetaminophen. It is preferred to nonsteroidal anti-inflammatory (NSAID) medications like ibuprofen, which have been shown to increase the risk of low amniotic fluid or problems with the fetal kidneys during pregnancy.
However, concerns were raised by a mass tort lawsuit about whether acetaminophen during pregnancy could lead to neurological issues in children. As per news reports, 66 cases have been documented in which plaintiffs blame drug store retailers for neglecting to caution them that taking acetaminophen (like Tylenol) during pregnancy could cause Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) in children. Pharmaceutical companies are, however, not named in the lawsuit.
Patients frequently get some information about the safety of taking acetaminophen and different meds while pregnant. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine’s national guidelines and recommendations have not changed.
Let’s Take A Look At What Research Says
Study 1
American Journal of Epidemiology, Masarwa et. al., 2018
An American Journal of Epidemiology meta-analysis on the use of acetaminophen during pregnancy combined data from 121 small studies. Researchers wound up with only 7 studies worth of relevant data. Based on that data set, they suggested that children whose mothers reported taking acetaminophen while pregnant might have an increased risk of ADHD (30%) and ASD (20%).
One of the examinations found no relationship between acetaminophen and disorders. And when acetaminophen was used for less than a week, none of the studies found an increased risk of ADHD. Acetaminophen and ASD or ADHD were not found to be linked in any way. Acetaminophen was not shown to be a proven cause of either condition, even though the data present opportunities for additional research.
There are three main issues with this particular data set:
1. The Studies Relied On Information “Remembered” By Patients.
Around 60% of study members remembered taking acetaminophen while pregnant only after their kids were old enough to be diagnosed – the mean age of children with ADHD, for instance, was 3 years of age. When a family receives a troubling diagnosis, they tend to think of any potential exposure or event that could have contributed to the outcome.
Furthermore, given the likelihood that taking acetaminophen could have been the guilty party, individuals are expected to misremember or misjudge to make sense of a neurological conclusion.
2. Mothers Over 31 Appeared To Be More At Risk.
Pregnancies after age 35 are by and large considered at a higher risk for birth defects. This might be because older mamas are bound to have pre-existing circumstances that lead to inflammation and chronic stress. These are possible explanations for the increased risk of ADHD and ASD in their children.
3. They Don’t Say Why The Participants Were On Acetaminophen.
Having a high fever might be an indication of a bacterial or viral infection and the treatment for it is the real culprit of developmental and neurological disorders. From 4 days to more than 28 days, the meta-analysis studied the durations of use.
The true risk factor might have been the underlying condition that caused the need for relief medication in the form of acetaminophen and that too if the participants took acetaminophen for more than a week at a time. Acetaminophen should not be taken long-term while pregnant, despite research indicating that occasional use is unlikely to harm the patient or fetus.
Attention Deficit Hyperactivity Disorder (ADHD) or similar behavior in children has a link with the use of acetaminophen while pregnant. Two more studies support this claim but they cannot prove causation which is why drawing specific conclusions from them is not possible.
Study 2
Danish Prospective Cohort, Liew et. al., 2014
This cohort study recorded 64322 pregnancies where mothers used acetaminophen during their pregnancy. Their 7-year-old children scored high for behavioral issues. By 11 years old, they recorded hyperkinetic disorder and prescriptions for ADHD medications.
Study 3
Norwegian Prospective Cohort, Brandilstuen et. al., 2013
This Norwegian study recorded 48631 pregnancies that focused on same-sex siblings. They found that mamas who used acetaminophen for 28 days minimum had 3-year-olds with
- Undeveloped gross motor skills
- Aggressive or attention-seeking behavior
- Reduced communication skills
- Increased activity
Both these studies suggested that longer use of acetaminophen in later pregnancy has some pretty strong associations even though the results were inconsistent. An important point to note here is that these two studies only show association and not causation which is why they are subjected to all “confounding” risks.
The least we can figure out is that women using acetaminophen during pregnancy have more headaches and pain which perhaps lead to ADHD in their children. But almost 55% to 65% of women use acetaminophen while pregnant because of the associative results of these studies.
A Final Word
Is acetaminophen safe for pregnancy? The bottom line is that acetaminophen should only be taken under strict medical advice when you are pregnant. Even then the safe duration of use for this pain reliever is 7 days at a stretch.
Beyond that, it might cause birth defects in kids. The research behind this claim does not have real-time recorded data which is why the studies are associative and not causative. Our best advice is to consult your trusted OB-GYN before taking acetaminophen or other medications during pregnancy.
