Is acetaminophen safe in pregnancy?

@article{Toda2017IsAS,
  title={Is acetaminophen safe in pregnancy?},
  author={Katsuhiro Toda},
  journal={Scandinavian Journal of Pain},
  year={2017},
  volume={17},
  pages={445 - 446}
}
  • K. Toda
  • Published 1 October 2017
  • Medicine
  • Scandinavian Journal of Pain

Acetaminophen is not Safe in Pregnancy

  • Medicine
  • 2018
TLDR
Acetaminophen is the safest medicine as analgesics for nociceptive pain and antipyretics in childhood and pregnancy and should be used only when needed and no safer option for pain or fever relief is available.

Prenatal and postnatal exposure to acetaminophen in relation to autism spectrum and attention-deficit and hyperactivity symptoms in childhood: Meta-analysis in six European population-based cohorts

TLDR
Prenatal exposure to acetaminophen was associated with ASC or ADHD symptoms and boys and girls showed higher odds for ASC and ADHD symptoms after prenatal exposure, though these associations were slightly stronger among boys.

Increased risk of preeclampsia after use of paracetamol during pregnancy – causal or coincidence?

TLDR
The use of paracetamol in the third trimester of pregnancy was associated with preeclampsia and this observation indicates that association between par acetamol use and pree clampsia is probably due to reverse causation, i.e. women with preeClampsia experience more headaches due to preeclamping symptoms since this association was not detected with the use ofParacetamols in earlier stages of pregnancy.

Intravenous paracetamol for neonates: long-term diseases not escalated during 5 years of follow-up

TLDR
Paracetamol exposure in neonatal life (pain, discomfort) is not associated with childhood disorders (asthma, atopic dermatitis, inflammatory bowel disease, autism, speech disorders, cerebral palsy) when compared to non-exposed cases at the age of 5 years in one NICU.

Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study

TLDR
The main findings of this prospective birth cohort study add to previous observations linking prenatal and early postnatal paracetamol exposure to asthma development, and recommend par acetamol to remain the analgesic and antipyretic of choice throughout pregnancy and early childhood.

Assessing the Knowledge of Analgesic Drugs Utilization during Pregnancy among Women in Saudi Arabia: A Cross-Sectional Study

TLDR
Pregnant women in Saudi Arabia have a good perception of the safest and most effective analgesic drug during pregnancy, but they have poor knowledge about analgesics’ side effects.

Self-medication practice in pregnant women from central Mexico

Medication Use among Pregnant Women from the 2015 Pelotas (Brazil) Birth Cohort Study

TLDR
Greater awareness of the risks of self-medication during pregnancy is required, focusing on groups more prone to this practice, as well as ensuring qualified multidisciplinary prenatal care.

We Must Judge Analgesic Effect of Analgesic Medicine

TLDR
The judgement of analgesic effect after analgesic medicine administration is the most basic of pharmacological treatment for pain and is classified into four categories: improvement, invariance, deterioration, and obscureness.

References

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Prenatal Use of Acetaminophen and Child IQ: A Danish Cohort Study

TLDR
Maternal acetaminophen use during pregnancy was associated with lower performance IQ in 5-year olds, however, acetamol treatment of maternal fever in pregnancy showed an apparent compensatory association with child IQ scores.

Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders.

TLDR
Maternal acetaminophen use during pregnancy is associated with a higher risk for HKDs and ADHD-like behaviors in children and because the exposure and outcome are frequent, these results are of public health relevance but further investigations are needed.

Acetaminophen Use for Fever in Children Associated with Autism Spectrum Disorder

TLDR
It is recommended that acetaminophen use be reviewed for safety in children and found that children with ASD vs. non-ASD children are significantly more likely to show an increase in sociability when they have a fever, and it is theorized that this increase is due to anandamide activation of the endocannabinoid system in ASD children with low endOCannabinoid tone from early acetamophen use.

Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled cohort study.

TLDR
Children exposed to long-term use of paracetamol during pregnancy had substantially adverse developmental outcomes at 3 years of age, and Ibuprofen exposure was not associated with neurodevelopmental outcomes.

Prenatal and infant exposure to acetaminophen and ibuprofen and the risk for wheeze and asthma in children.

Acetaminophen use and the risk of asthma in children and adults: a systematic review and metaanalysis.

TLDR
The results of this review are consistent with an increase in the risk of asthma and wheezing in both children and adults exposed to acetaminophen.

Prenatal and infant paracetamol exposure and development of asthma: the Norwegian Mother and Child Cohort Study.

TLDR
Evidence is provided that prenatal and infant paracetamol exposure have independent associations with asthma development and the findings suggest that the associations could not be fully explained by confounding by indication.

The case of drug causation of childhood asthma: antibiotics and paracetamol

TLDR
The weight of evidence of the collected studies in this review strongly suggests that the association of antibiotics with childhood asthma reflects various forms of bias, the most prominent of which is confounding by indication.

Prenatal paracetamol exposure is associated with shorter anogenital distance in male infants

TLDR
Intrauterine paracetamol exposure during 8–14 weeks of gestation, but not any other period, was associated with shorter AGD from birth to 24 months of age, and this reduction was independent of body size.

Neurodevelopmental problems at 18 months among children exposed to paracetamol in utero: a propensity score matched cohort study.

TLDR
Long-term exposure to paracetamol in utero was associated with modestly increased risks of motor milestone delay and impaired communication skills among children at 18 months; however, women with severe pain conditions should not be deprived of appropriate pharmacotherapy.