If you’re pregnant and in pain, there’s not much in your medicine cabinet you can safely turn to (Aspirin is out because it can cause congenital defects, ditto for ibuprofen, which can increase your risk of miscarriage). Now it seems your options may have dwindled even further. A new study in the International Journal of Epidemiology has found a link between acetaminophen and autism.
This is a problem because acetaminophen has long been considered the safest treatment of choice for expectant mothers—and some research suggests it could even help decrease the risk of some birth defects when used to treat fever in pregnant women.
In the study, Spanish researchers questioned 2,644 women about their use of paracetamol (acetaminophen) during pregnancy and, when they assessed their children at age five, found that children exposed to the drug in utero were at a 30 percent higher risk of hyperactivity and impulsive behaviour. They also found an increase in two clinical symptoms of autism in boys whose mothers regularly took the painkiller.
So, does this mean moms-to-be will have to suffer in silence? Not according to David Olson, a professor of obstetrics and gynecology, pediatrics and physiology at the University of Alberta in Edmonton. First of all, he says, there are some limitations to the study.
“The effects were observed in women who were less well-educated, smoked during pregnancy and had chronic illnesses or fever that was not explained,” he says. “There was also no description of the other medications these women were taking—and if they were taking acetaminophen during pregnancy, there is a likelihood they may have been taking other drugs, so there might be a confounding effect.”
Olson says that although the effects were significant in the areas mentioned by the study, they were small and also didn’t apply to all parameters of attention function or autism. “More carefully controlled studies are necessary, and several other conditions need to be investigated, in order to pin acetaminophen as the culprit.”
Laura Gaudet, a perinatologist at The Ottawa Hospital and associate scientist at the Ottawa Hospital Research Institute, agrees. “It’s important to weigh the merits of each study that comes out carefully, especially as research in obstetrics is particularly hard to do,” she says. “In this case, you have to remember that association and causality are two very different things.”
Still, Olson says the findings are a warning that pregnant women should watch their acetaminophen intake, just to be safe. “But that applies to the consumption of all drugs,” he says. “It’s not a warning that women should stay completely clear of acetaminophen.” He also recommends trying non-pharmaceutical relief for pain, such as mind-body relaxation techniques and massage.
“The key when you’re treating health issues during pregnancy is always to use the safest medication you can at the lowest dose possible,” Gaudet adds. “And because it requires a constant balance based on individual needs, you should always do it with the help of your doctor, because they’re the ones who can give you the best advice.”