The Times Australia
The Times World News

.

Take care with paracetamol when pregnant — but don't let pain or fever go unchecked

  • Written by Luke Grzeskowiak, Channel 7 Children's Research Foundation Fellow in Medicines Use and Safety - Flinders University & South Australian Health & Medical Research Institute, Flinders University
Take care with paracetamol when pregnant — but don't let pain or fever go unchecked

Pregnancy comes with aches and pains and heightened anxiety about what we put into the body.

A new article published in Nature Reviews Endocrinology[1] has urged caution around taking paracetamol during pregnancy. The paper is a “consensus statement” that brings together analysis by a panel of experts who looked at evidence from human and animal studies of paracetamol use in pregnancy.

Paracetamol use during pregnancy may alter fetal development, say the authors, with long-lasting effects on child health. The authors call for improved education for health-care professionals and patients, less paracetamol use during pregnancy and further research.

Alert but not alarmed

At first glance, calls to minimise paracetamol use during pregnancy are alarming. For those who have taken paracetamol (commonly marketed in Australia as Panadol, Herron Paracetamol, Panamax, Chemist Own or Dymadon) during pregnancy, this could cause anxiety.

This new consensus statement calls for caution, but not concern. The proposed recommendations are largely consistent with current advice[2] provided to pregnant women in Australia.

With any medication in pregnancy, there needs to be a careful balance between treating a maternal condition and protecting the unborn. A trusted health care provider can help reach an informed decision. Paracetamol is no different.

pill packet
Paracetamol is the active ingredient in hundreds of prescription and non-prescription medications. Shutterstock[3]

What are the concerns?

Worldwide, more than 50% of pregnant women[4] use paracetamol to treat pain and/or fever. Paracetamol is the active ingredient in hundreds of prescription and non-prescription products. It has been widely regarded for many years as safe to use during pregnancy.

Some, but not all, observational studies in humans suggest paracetamol use during pregnancy may alter fetal development[5]. The new statement notes that paracetamol has been linked to increased risk of certain neurodevelopmental, reproductive and urogenital disorders[6].

But these studies have limitations. Researchers have found it hard to distinguish the effects of paracetamol from the effects of underlying illness. And there are potential inaccuracies in recording the amount and timing of paracetamol use across an entire pregnancy as are highlighted in the accompanying editorial[7].

Possible risks of paracetamol use in pregnancy are supported by a number of animal studies, the authors say. For this reason, caution regarding paracetamol use has been advised until a definitive link can be proven or disproven.

It’s worth noting the available evidence suggests any possible harms of paracetamol are likely to be dose-related. As highlighted by the review article, most increased risks have been linked with use in pregnancy for more than two or four weeks[8]. Current evidence suggests limited risks to unborn babies when paracetamol is taken short term.

Timing is also important. Taking paracetamol during the first trimester has been linked to an increased risk of reproductive and urogenital disorders. Neurodevelopmental disorders have been linked to use in the second or third trimester.

Read more: Domperidone can boost breast milk supply – here's what you need know[9]

When the benefits outweigh the risks

The potential benefits of taking medication need to be weighed against any possible risks. Paracetamol is recognised as an important medication for treating pain and fever during pregnancy.

If left untreated, these conditions could harm the fetus or the pregnant person (the Nature editorial[10] and statement[11] say the expert advice is “relevant for all people who wish to become pregnant, including transgender individuals, non-binary people and intersex people”).

The review authors recognise the potential benefits of paracetamol use[12] and note untreated pain has been linked to increased risks of depression or anxiety as well as hypertension during pregnancy. Fever in pregnancy is a risk factor for multiple neonatal and childhood disorders, including certain birth defects and miscarriage. There is evidence to suggest that use of paracetamol may reduce these risks.

Read more: Using cannabis during pregnancy could be bad news for your baby: new research[13]

What are the alternatives?

The optimal management of pain or fever during pregnancy has not been well studied and treatment options remain limited.

Non-steroidal anti-inflammatory medications (such as ibuprofen) have been linked to miscarriage[14] when used in the first trimester, whereas use after 30 weeks’ gestation can negatively impact kidney and heart/lung function[15] in the fetus. For this reason non-steroidal anti-inflammatory medications are best avoided[16] unless advised by a healthcare professional. The same goes for strong pain medications such as opioids, which should be reserved for the management of severe pain[17]. Paracetamol remains the best choice for the short-term treatment of pain and/or fever during pregnancy.

It is also important to identify the cause of the pain or fever, particularly during pregnancy. Discussions about paracetamol use can lead to further investigation, recommendations for non-medication treatments or the need for different medications.

pregnant woman with sore back Safe options for pain management during pregnancy are limited. Shutterstock[18]

Read more: Weight gain during pregnancy: how much is too much?[19]

The bottom line

The new consensus statement does not alter existing recommendations regarding paracetamol use during pregnancy. But it does highlight the importance of thinking carefully before using any medications during pregnancy and raises greater awareness about how challenging making informed decisions about medication use can be.

Better evidence is needed to support decision-making during pregnancy and reduce unnecessary anxiety and concern.

Paracetamol use during pregnancy should be discussed with a health-care professional and used at the lowest effective dose for the shortest possible duration. Non-medication therapies for treating pain or fever should be tried before or in addition to paracetamol. When indicated, short-term use of paracetamol remains the safest medication for the treatment of pain and/or fever during pregnancy.

References

  1. ^ Nature Reviews Endocrinology (www.nature.com)
  2. ^ current advice (www.nps.org.au)
  3. ^ Shutterstock (image.shutterstock.com)
  4. ^ more than 50% of pregnant women (academic.oup.com)
  5. ^ alter fetal development (pubmed.ncbi.nlm.nih.gov)
  6. ^ neurodevelopmental, reproductive and urogenital disorders (www.nature.com)
  7. ^ editorial (www.nature.com)
  8. ^ more than two or four weeks (www.nature.com)
  9. ^ Domperidone can boost breast milk supply – here's what you need know (theconversation.com)
  10. ^ editorial (www.nature.com)
  11. ^ statement (www.nature.com)
  12. ^ potential benefits of paracetamol use (www.nature.com)
  13. ^ Using cannabis during pregnancy could be bad news for your baby: new research (theconversation.com)
  14. ^ miscarriage (obgyn.onlinelibrary.wiley.com)
  15. ^ kidney and heart/lung function (obgyn.onlinelibrary.wiley.com)
  16. ^ best avoided (www.medicinesinpregnancy.org)
  17. ^ reserved for the management of severe pain (www.nps.org.au)
  18. ^ Shutterstock (image.shutterstock.com)
  19. ^ Weight gain during pregnancy: how much is too much? (theconversation.com)

Read more https://theconversation.com/take-care-with-paracetamol-when-pregnant-but-dont-let-pain-or-fever-go-unchecked-168747

Times Magazine

What AI Adoption Means for the Future of Workplace Risk Management

Image by freepik As industrial operations become more complex and fast-paced, the risks faced by workers and employers alike continue to grow. Traditional safety models—reliant on manual oversight, reactive investigations, and standardised checklist...

From Beach Bops to Alpine Anthems: Your Sonos Survival Guide for a Long Weekend Escape

Alright, fellow adventurers and relaxation enthusiasts! So, you've packed your bags, charged your devices, and mentally prepared for that glorious King's Birthday long weekend. But hold on, are you really ready? Because a true long weekend warrior kn...

Effective Commercial Pest Control Solutions for a Safer Workplace

Keeping a workplace clean, safe, and free from pests is essential for maintaining productivity, protecting employee health, and upholding a company's reputation. Pests pose health risks, can cause structural damage, and can lead to serious legal an...

The Science Behind Reverse Osmosis and Why It Matters

What is reverse osmosis? Reverse osmosis (RO) is a water purification process that removes contaminants by forcing water through a semi-permeable membrane. This membrane allows only water molecules to pass through while blocking impurities such as...

Foodbank Queensland celebrates local hero for National Volunteer Week

Stephen Carey is a bit bananas.   He splits his time between his insurance broker business, caring for his young family, and volunteering for Foodbank Queensland one day a week. He’s even run the Bridge to Brisbane in a banana suit to raise mon...

Senior of the Year Nominations Open

The Allan Labor Government is encouraging all Victorians to recognise the valuable contributions of older members of our community by nominating them for the 2025 Victorian Senior of the Year Awards.  Minister for Ageing Ingrid Stitt today annou...

The Times Features

How to Know If You’re Actually on Track for a Comfortable Retirement

Image by Drazen Zigic on Freepik It’s the kind of question that sits in the back of your mind, especially as you tick past your 30s or 40s: Am I actually saving enough for retire...

Onsite Caterer vs a Full Service Venue: 9 important things to explore

Choosing between an external catering company and an all-inclusive venue is a major decision that affects cost, flexibility, food quality, and the overall event experience. Venue...

The Hidden Vision Problem Impacting Mid Life Australians Every Day

New research from Specsavers reveals millions of Australians are living with an undiagnosed condition that could be putting their safety at risk. For many Australians aged 35 ...

Meal Prep as Self-Care? The One Small Habit That Could Improve Your Mood, Focus & Confidence

What if the secret to feeling calmer, more focused, and emotionally resilient wasn’t found in a supplement or self-help book — but in your fridge? That’s the surprising link uncov...

From a Girlfriend’s Moisturiser to a Men’s Skincare Movement: How Two Mates Built Two Dudes

In a men’s skincare market that often feels like a choice between hyper-masculinity and poorly disguised women’s products, Two Dudes stands out. It’s not trying to be macho. It’s n...

The Great Fleecing: Time for Aussies to demand more from their banks

By Anhar Khanbhai, Chief Anti-Fleecing Officer, Wise   As Australians escape the winter chill for Europe’s summer or Southeast Asia’s sun, many don’t realise they’re walking strai...