Is Acetaminophen Safe During Pregnancy? New Study Links It To ADHD Risk

Acetaminophen, commonly known as paracetamol, is one of the few painkillers considered safe for use during pregnancy. However, recent research has raised concerns about its potential impact on a baby’s brain development. A new study suggests that the widely used medication may be linked to an increased risk of attention deficit hyperactivity disorder (ADHD) in children.

What the Study Found

Researchers in the United States tracked acetaminophen levels in the bloodstreams of 307 Black pregnant women. Their findings revealed that children born to mothers who had used acetaminophen were over three times more likely to be diagnosed with ADHD. The risk appeared even higher for female children, who were more than six times as likely to develop ADHD within their first ten years of life.

While these findings may sound alarming, experts emphasize that this study alone is not conclusive. Many pregnant women rely on acetaminophen to manage pain or fever, which can themselves be harmful if left untreated. The study shows the need for further research rather than an immediate change in medical guidelines.

The Debate Over Acetaminophen Safety

Acetaminophen is widely recommended by health organizations, including the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the American College of Obstetricians and Gynecologists (ACOG). These institutions maintain that acetaminophen is generally safe when used at the lowest effective dose for the shortest duration necessary.

However, paediatrician Dr. Sheela Sathyanarayana from UW Medicine argues that the drug's long-term effects on fetal development have not been thoroughly studied. "This medication was approved decades ago and may need reevaluation by the FDA," she stated. "Acetaminophen was never evaluated for fetal exposures in relation to long-term neurodevelopmental impacts."

Conflicting Research and Concerns

Over the past few years, multiple studies have investigated potential links between acetaminophen use during pregnancy and neurodevelopmental disorders like ADHD and autism spectrum disorder (ASD). Some studies have reported associations, while others have not found strong enough evidence to confirm a direct connection.

One challenge in assessing acetaminophen’s impact is accounting for other factors that may contribute to ADHD risk. For example, pregnant women often take acetaminophen for conditions such as fever, infections, or chronic pain, which themselves could influence a child’s development.

Statistical geneticist Viktor Ahlqvist from Sweden’s Karolinska Institute, who was not involved in the study, cautions against drawing firm conclusions too soon. "The study does not account for factors like the mother's reason for taking acetaminophen, which we know are risk factors for adverse child development," he told New Scientist.

Calls for Caution and Further Investigation

Despite the conflicting research, some scientists believe that precautionary steps should be taken. In 2021, a group of 91 international scientists, clinicians, and public health professionals published a Consensus Statement in Nature Reviews Endocrinology. They recommended that pregnant women take extra caution when using acetaminophen, including:

- Only use it when medically necessary.

- Consult a doctor or pharmacist before taking it regularly.

- Using the lowest effective dose for the shortest time possible.

However, major health organizations have not yet changed their stance. In response to these concerns, ACOG issued a statement reaffirming their position: "Neurodevelopmental disorders are multifactorial and very difficult to associate with a singular cause. The brain does not stop developing until at least 15 months of age, which leaves room for children to be exposed to a number of factors that could potentially lead to these issues."

What This Means for Pregnant Women

For now, the general recommendation remains unchanged: Acetaminophen can be used during pregnancy, but only as needed and in the lowest effective dose. Pregnant women experiencing pain or fever should consult their healthcare provider before taking any medication. While this new study raises important questions, experts agree that further research is needed to draw definitive conclusions.

The study was published in Nature Mental Health and is expected to prompt further investigations into the long-term effects of acetaminophen use during pregnancy.

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