Paracetamol is one of the most widely used drugs in the world. In pregnancy, it has been generally regarded as safe and is often, one of the few medications accessible for those feeling unwell when pregnant. However, recent evidence is emerging that paracetamol might not be as safe as we’ve been led to believe.
Animal studies have shown its use may affect neurodevelopment and cognitive function and disrupt brain derived neurotropic factor (BDNF). Human research also highlights potential risks of increased hyperkinetic disorders and ADHD type behaviour in children when used in pregnancy, although other behavioural or social factors were not accounted for.
Considering these potential confounding factors, a 2016 longitudinal study of 7796 mothers has revealed that this pharmaceutical, taken prenatally, may increase the risk of multiple behavioural difficulties in the offspring.
Use in the second (18 weeks) and third (32 weeks) trimesters of pregnancy was shown to be associated with significantly increased risk of conduct problems and hyperactivity symptoms in the children. The effects were greater in the third trimester, with the added risks of emotional symptoms and higher total difficulty scores. The study also reported that no adverse effects are associated with paracetamol use postnatally or by partners.
The authors concluded that children exposed to acetaminophen prenatally are at increased risk of multiple behavioral difficulties and that more research is needed to replicate the findings and understand the mechanisms.
- Stergiakouli E, Thapar A, Davey Smith G. Association of acetaminophen use during pregnancy with behavioral problems in childhood: evidence against confounding. JAMA Pediatr 2016 Oct 1;170(10):964-970. [Abstract]