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Children’s Health | Cleveland Clinic News Wire | Pregnancy & Childbirth | Women’s Health
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Are You Pregnant? Avoid Heavy Acetaminophen Use

Discuss ways to manage pain with your doctor

Two new studies may make you more cautious about using medication to ease those pregnancy aches and pain. Researchers have found developmental problems in some children whose mothers were heavy users of acetaminophen (Tylenol®) during their pregnancies.  

It’s important to note that numerous studies have consistently shown acetaminophen to be safe to use during pregnancy. This prior research was generally focused on premature birth or miscarriage.

However, a new study published in the International Journal of Epidemiology takes a close look at how heavy acetaminophen in pregnancy could affect a young child’s development.

Here’s what this study found:

  • The Norwegian researchers looked at more than 48,000 3-year-old children. They surveyed the mothers about medications they used during pregnancy. They asked specifically about acetaminophen use at weeks 17 and 30 of pregnancy, as well as six months after giving birth.
  • About four percent of those moms said they used acetaminophen heavily during pregnancy (28 days or more).
  • The researchers found that the children of those heavy acetaminophen users exhibited poorer gross motor development and language skills and more behavior problems.

Behavioral problems

Another study, just published in JAMA Pediatrics, found that using acetaminophen during pregnancy was also associated with behavioral problems in children — particularly attention-deficit/hyperactivity disorder (ADHD) and hyperkinetic disorders (a severe form of ADHD).

This study involved 64,322 Danish children and mothers. Parents reported behavioral problems on a questionnaire, and researchers collected ADHD medication prescriptions from Danish registries. By taking a close look at this data, researchers found an association between acetaminophen use during pregnancy and behavioral problems in some children.

What the findings mean

Here’s what you should know about these findings:

  • Association is not causation. That means that it’s hard to say whether the medication caused these developmental problems as opposed to, say, the cause of the pain to begin with. As with any new research, we won’t change our recommendations to patients until the findings can be substantiated by other studies. The population in Norway might not be representative of the population where you live.
  • Don’t panic if you’ve used some acetaminophen during your pregnancy. Taking some acetaminophen here and there for back pain shouldn’t be a cause for concern. The women who took part in this study were heavy acetaminophen users, meaning that they reported 28 days or more of use during their pregnancies.
  • Don’t turn to ibuprofen or aspirin as an alternative. There are good reasons why doctors recommend acetaminophen as opposed to ibuprofen or aspirin during pregnancy. Studies have shown dangerous side effects of ibuprofen use after 32 weeks of pregnancy.
  • Avoid all medications if you can. Pain is a pretty common part of pregnancy, whether it’s back pain, achy joints or headaches. Doctors often recommend acetaminophen as a treatment for mild pain during pregnancy rather than ibuprofen (Motrin®) or aspirin, but my best advice to patients is to avoid using any medications during pregnancy unless they’re absolutely necessary.

More information

Tags: acetaminophen, fevers, miscarriage, pregnancy, pregnant
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Elisa Ross, MD, is a obstetrician and gynecologist in Cleveland Clinic’s Women’s Health Institute. She loves caring for and educating women.

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