One of the things I love most about the medical community is our desire to continually find better answers and care methods through research. But occasionally, sharing the findings of a new study can lead to unnecessary concern and confusion – particularly if the results are not clearly communicated. Show Such is the case with recent recommendations on acetaminophen use during pregnancy. Acetaminophen, also called paracetamol, is a mild pain-relieving drug commonly found in over-the-counter pain and cold medications such as Tylenol. It has generally been considered safe to use during pregnancy. But in September 2021, a consensus statement urging caution on the use of acetaminophen during pregnancy was published in Nature Reviews Endocrinology. Drafted by an international team of obstetricians, pediatricians, neurologists, and scientists with expertise in fetal development, toxicology, and endocrinology, the statement specifically recommends that pregnant patients:
These guidelines are no different from what we’ve already been telling patients. Whether we’re prescribing medication or performing ultrasounds, our advice during prenatal care is always to use the least amount of exposure (to any drug or sound waves) to get the necessary benefits. The authors based their statement on recent studies suggesting that acetaminophen could potentially harm a pregnancy. Understandably, this has caused a wave of concern among pregnant patients – 80% of whom report taking at least one medication while pregnant, with acetaminophen accounting for 65% of medications used. However, many national Ob/Gyn organizations say there is no evidence to indicate concern. Related reading: Know the risks of taking ibuprofen, NSAIDs during pregnancy What prompted the new statement on acetaminophen use?Previously, the U.S. Food and Drug Administration (FDA) had labeled acetaminophen as “Category B,” meaning no studies had demonstrated it caused birth defects in animals. Like many medications, no specific studies involving pregnant women were performed. Recent research suggests that prenatal exposure to acetaminophen might alter fetal development and increase the risks of certain neurodevelopmental, reproductive, and urogenital disorders. Acetaminophen can cross the placenta, meaning it can enter the fetal bloodstream through a patient’s blood when they take the medication. While this was considered harmless in the past, there’s now concern that acetaminophen could act as an endocrine disruptor, potentially interfering with hormonal processes that influence the development of the baby’s nervous and reproductive system. In some animal studies, acetaminophen exposure was associated with:
Epidemiologic studies, which analyze patterns and causes of certain conditions in specific populations over a designated time period, also have indicated an association between prenatal acetaminophen exposure and reproductive or nervous system abnormalities. Scientists observed the reproductive development of several children across the globe whose mothers had taken acetaminophen during pregnancy. Some studies suggested that:
However, many studies showed no correlation. Those that did were limited by factors such as patient self-reporting and residual confounding – additional factors that could have affected the study results but were not considered. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. aches and pains… as anyone who has been pregnant likely knows! Pregnant women may experience a variety of symptoms from breast tenderness and leg cramps in their first and second trimester to Braxton Hicks contractions in the third, and chances are at some point they’ll be reaching into the medicine cabinet for some pain relief.RELATED: What medications are safe to take during pregnancy? Is it safe to take pain medications while pregnant?Taking pain medicine while pregnant can be cause for uncertainty, but it’s also a commonly reported medication taken during pregnancy. According to The Centers for Disease Control (CDC), 9 out of 10 pregnant women reported taking pain medication during pregnancy. The CDC does caution women who are pregnant, or trying to conceive, against using specific pain medications and recommends that patients consult with their medical health provider prior to taking any medications or supplements while pregnant. But that doesn’t mean you’re out of pain options. Which pain medications are best to take during pregnancy?The shortest answer is: take Tylenol while pregnant, not ibuprofen or other NSAIDs. RELATED: Is Tylenol an NSAID? Tylenol while pregnant: Safe“Acetaminophen, such as Tylenol, is the safest option to take during pregnancy; however, take as little of it as possible for the shortest course,” says Soma Mandal, MD, a board-certified internist at Summit Medical Group in Berkeley Heights, New Jersey. “Women who took acetaminophen were less likely to have birth defects,” Dr. Mandal says of the study. While acetaminophen may be the drug of choice when looking for pain relief while pregnant, it’s still important to read the labels every time you purchase medication. “Avoid combination medications, so you do not end up taking an unnecessary medication or a dangerous medication,” says Danielle Plummer, Pharm.D., the founder of HG Pharmacist. “For example, Excedrin has not only acetaminophen but also aspirin and caffeine, so avoid it.” Get acetaminophen coupon Ibuprofen while pregnant: Not safeThe CDC cautions against pregnant women taking non-steroidal anti-inflammatory drugs (NSAIDs)—which includes ibuprofen, as well as opioids during pregnancy—after a study was conducted that linked these types of pain medications with an increase in birth defects. Studies show that use of NSAIDs increase the chance of spontaneous miscarriage, with one study stating that prenatal use of NSAIDs increased the chance of miscarriage by 80%. Drs. Plummer and Mandal both warn that ibuprofen may be the more popular NSAID, but there are many other pain medications that should be avoided during pregnancy. These include:
RELATED: Acetaminophen vs. ibuprofen What are some alternative pain relief options during pregnancy?“Depending on the type and location of the pain, I recommend to start by using ice or alternating ice and heat,” says Dr. Plummer, who cautions that you don’t put the ice directly on the skin. She recommends wrapping an ice pack in a towel, or using a bag of frozen peas or a product specifically designed for pain. Some other alternatives that Dr. Plummer recommends include:
When your quality of life is affected, and the natural solutions aren’t cutting it, then acetaminophen is an acceptable pain relief option during pregnancy. Get Tylenol coupon Always talk to your healthcare provider before taking medication while pregnant. The CDC also recommends the online website |
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