Among the few drugs that pregnant women rely on so far is paracetamol: an over-the-counter medicine, commonly used to relieve fever and pain of various kinds. But according to a new study just published on Nature Reviews Endocrinology, the methods of administration should be reviewed as soon as possible, recommending it only under strict medical supervision, at the lowest effective dose and for the shortest possible time.
This is because researchers at the University of Copenhagen have found that the painkiller can affect fetal development and increase the risk of brain and reproductive disorders in the unborn child. In short, not good news, although for the moment it remains “the safest drug available to treat pain and fever in pregnant women”.
“Paracetamol is a drug with an unclear mechanism of action that is widely used to reduce fever and relieve mild to moderate pain even during pregnancy, with estimates suggesting use in up to 65% of pregnant women in all. However, an increasing amount of research suggests that prenatal exposure may affect fetal development, which could increase the risk of certain neurodevelopmental, reproductive and urogenital disorders, “writes Dr. David Kristensen, lead author of the newly published study, also reviewed and shared by independent experts.
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The crux of the matter is that, as there is a lack of gender-specific trials and drugs, there are not enough human experimental studies on the long-term consequences of moderate use of paracetamol in pregnancy.
Kristensen and colleagues conducted a review of experimental animal and cell research and epidemiological research related to the use of paracetamol in pregnancy, published between January 1, 1995 and October 25, 2020, reporting that “prenatal exposure may be associated with adverse outcomes “, therefore it is necessary to” moderate its use “, only on prescription and at low doses.
“Paracetamol remains an important and commonly used drug with few alternatives available, so women should be informed in early pregnancy and know that they should limit its use,” the authors write, asking the scientific world “for greater effort to target study how paracetamol affects human fetal development “, the EMA and the FDA” to review the available epidemiological and experimental data to make an evidence-based risk assessment available “and proposing a series of measures to doctors and women” precautions that should be taken in the meantime “.
While these recommendations do not differ substantially from current general advice on drug use in pregnancy, the authors believe it is important to “communicate the specific risk of paracetamol to both healthcare professionals and pregnant women”, as paracetamol appears to be “the most used drug without medical supervision because of the perception that there is a negligible risk on the unborn child”.
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Acetaminophen – or paracetamol, as we all call it – is an endocrine disruptor and can reach the fetus causing disorders such as cryptorchidism, failure to descend testicles in children, reduce testosterone levels with long-term effects on puberty and fertility , lead to abnormalities in the formation of the uro-genital system and in the development of the brain, with an increase in cases of attention deficit, hyperactivity disorder and language delays.
To minimize these risks, “pregnant women should forgo the use of acetaminophen unless prescribed by their doctor. During pregnancy, the use of antipyretics is important for the treatment of high fever which, if left untreated. , it could potentially affect the developing fetus, but only a third of pregnant women use it for this reason. ” That is why all the others “should limit it immediately”.
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