According to a large international study, the consumption of paracetamol during pregnancy could cause adverse effects on the development of the fetus.
- This large meta-analysis confirms that the consumption of paracetamol during pregnancy could alter the reproductive health and neurological development of the fetus.
- The use of paracetamol in pregnant women should be reserved for cases of necessity and always be preceded by the advice of a doctor or pharmacist.
When you are pregnant, it is strongly recommended not to consume alcohol, to pay attention to your diet and not to practice self-medication. Even when it comes to drugs perceived as harmless like paracetamol.
This is highlighted by a new international meta-study published Thursday, September 23 in the journal Nature Reviews Endocrinology. According to its 91 authors, experts in different specialties (neurology, pediatrics, gynecology, endocrinology, etc.), the consumption of paracetamol during pregnancy “may impair fetal development, which may increase the risk of certain neurodevelopmental, reproductive, and urogenital disorders”. They therefore recommend a moderate use of paraceramol, which should only be used by patients after consulting their doctor.
Paracetamol, not always perceived as a “real” medicine
When you are pregnant, paracetamol is the only analgesic that can be prescribed to relieve mild to moderate pain and fever. On his websitethe National Medicines and Health Products Agency (ANSM) recalls that “if necessary, paracetamol can be used during pregnancy. However, it should be used at the lowest effective dose, for the shortest possible duration and at the lowest possible frequency”.
However, recalled David M. Kristensen, one of the authors of the study and associate professor of cell biology and physiology at the University of Copenhagen (Denmark), “many people do not consider paracetamol as a real medicine that can have possible side effects”.
But taking any medication involves risks, recalls this study, which is based on the existing literature on the links between the effects of paracetamol and the unborn child between January 1, 1995 and October 25, 2020. Only studies directly investigating exposure to paracetamol were retained in order to prevent other factors, such as age, genetics or socio-economic situation from distorting the results.
Effects on fertility and the nervous system
Scientists have been studying the potential impact of paracetamol on fetal development for some time. “There is now a significant body of evidence to suggest that paracetamol impairs reproductive development in animals and humans”explains co-author Shanna Swan, professor of environmental medicine and public health at the Icahn School of Medicine at Mount Sinai in New York.
The known risks are those of undescended testicles and a shortening of the ano-genital distance, “which predicts a subsequent decrease in sperm count and a decline in fertility”, continues the researcher. “We also see impaired ovarian function that has implications for later fertility, although women have been studied less.”
Too much paracetamol consumption also has effects on the neurological development of the future child. “The disorders identified were primarily attention deficit hyperactivity disorder, or ADHD, and ADHD-related behavioral abnormalities, which also include autism spectrum disorders, language delays, decreased IQ, and behavior”explains Ann Bauer, who also participated in the study.
Better inform pregnant women about the risks
The authors note, however, that short-term use – two weeks or less – carried the least risk to the fetus. “The strongest associations are found among women who report using acetaminophen for a longer period of time – around two weeks or more than two weeks during pregnancy”, explains Professor Kristensen. The authors believe that “Further research is needed to understand the mechanisms and control other exposures. But the fact is there is substantial evidence to suggest that, at a minimum, there is harm to the fetus”.
Hence the need for health professionals to measure the risks of paracetamol consumption in pregnant women, and to take them into account when prescribing. They should also warn pregnant women to “give up the use” paracetamol during pregnancy “unless its use is medically indicated”. Even after obtaining a doctor’s approval, women must “minimize their exposure by using the lowest effective dose for the shortest possible duration”.
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