the Research letter is a short version of interesting scientific work.
The big idea
Increasing evidence shows that the use of acetaminophen – widely known under the brand name Tylenol – during pregnancy poses risks to the fetus and early childhood development. That was the conclusion of a new overview study on which I was one of the main authors.
Acetaminophen, which has the chemical name acetaminophen, is an over-the-counter medication that doctors recommend often for pain relief and lowering fever.
Our study, based on an assessment of 25 years of research in human epidemiology, animal and in vitro studies, concludes that prenatal exposure to acetaminophen may increase the risk of improper development of reproductive organs. We are at increased risk of neurodevelopmental disorders, primarily attention deficit hyperactivity disorder and related behaviors, but also autism spectrum disorder as well as speech delays and decreased IQ.
In our consensus statement – broad approval from our multidisciplinary international panel of experts – published in Nature Reviews Endocrinology in September 2021, 91 clinicians and researchers call for caution and additional research.
Which is not yet known
It is unethical to conduct experiments that could harm a human life. To better understand the direct effects of acetaminophen during pregnancy, we must rely on human observational and experimental studies to assess the possibility of causal relationships. But to really answer these questions, we need human cohort studies that can capture exactly when and why paracetamol is taken during pregnancy. In addition, we want research that enables us to better understand biological metabolic pathways.
The current almost ubiquitous use of acetaminophen during pregnancy is due in part to that widespread perception – even among doctors – that it has limited side effects and negligible risk. But a growing body of research suggests that the indiscriminate use Paracetamol during pregnancy – especially with diseases such as chronic pain, Lower back pain and headache – can be unjustified and unsafe.
In our consensus statement, we call for health professionals and pregnant women to be educated about the risks and benefits of taking acetaminophen during pregnancy.
Based on our extensive review of the evidence – and recognizing that there are limited alternatives to the necessary treatment for high fever and severe pain – we recommend that pregnant women avoid acetaminophen unless medically recommended by a doctor. Women should also minimize the risk to the fetus by using the lowest effective dose for the shortest possible time.
This article was updated on October 4, 2021 to include a statement from Johnson & Johnson.
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