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Using paracetamol during pregnancy may alter foetal development

Several studies have shown that prenatal exposure to paracetamol may alter foetal development. It has been shown to increase the risk of certain minor neurodevelopmental disorders, as well as potentially having urogenital and reproductive effects.

Paracetamol during pregnancy can cause minor neurodevelopmental disorders as well as reproductive and urogenital effects on the foetus

Paracetamol is a drug that is widely used to reduce febrile states and treat moderate pain. Recently, epidemiology has shown that using this drug during pregnancy may cause minor neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and reproductive and urogenital disorders. What was previously considered a safe medication during pregnancy should now only be used with a prescription, especially in cases of high fever and severe pain, as these can also affect foetal development.

The majority of women are reluctant to take medication during pregnancy, however 8 out of 10 women have taken paracetamol while pregnant. It is estimated that 65% of pregnant women use paracetamol in the USA, compared to 50% globally. Based on current evidence, it is recommended that pregnant women use this drug with caution, especially in the first trimester of pregnancy.

Paracetamol is an endocrine disruptor, a drug that can interfere with normal hormonal activity and affect the body’s proper functioning. It can cause male reproductive function disorders, metabolic and neurological disorders, and diseases related to women's reproductive health.

Excessive consumption of paracetamol during pregnancy can have consequences from infancy to adolescence. Some studies in pregnant women have shown that this drug has urogenital and reproductive effects on the foetus, for example an increased risk of genital malformations such as a shorter than normal distance between the anus and genitals. It has also been observed that the testes do not descend normally during foetal development, and other studies have reported an early onset of puberty in girls.

This drug is able to cross the placenta and the blood-brain barrier, which regulates the entry of different molecules into the brain. The brain is an organ that undergoes its greatest development in the mother's womb and in infancy, times during which it is most vulnerable to exposure to toxins. During these stages, certain drugs such as paracetamol can cause neurodevelopmental effects, even at low levels. The greater the exposure, the greater the risk that the child will develop attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) or language delays, or that they will have a lower than average IQ.

Ibuprofen may be considered as an alternative to paracetamol, but although it also has analgesic properties, it is an anti-inflammatory drug that is contraindicated during the first trimester of pregnancy. This means there are few pharmacological alternatives to paracetamol for the treatment of fever and pain.

A recent paper presented by researchers in Europe and America compiled the available scientific evidence and recommended that pregnant women should use paracetamol when it is medically indicated, and should not use it for minor ailments such as back pain. When it is necessary, it should be taken in the lowest possible dose and for the shortest possible time.

Documented Information by: Dr. Eduard Gratacós, director at Institut Clínic de Ginecologia, Obstetrícia i Neonatologia (ICGON), and Principal Investigator of the Fetal and perinatal medicine at Clinic-IDIBAPS