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Overview
Acetaminophen (also known as Tylenol or paracetamol) is widely used for pain and fever relief during pregnancy. Current evidence and clinical guidelines generally support its use when needed, but there is ongoing research and some debate about possible risks, especially with frequent or prolonged use.
Key Points
Safety and Clinical Guidelines
- General Safety: Acetaminophen is considered the safest over-the-counter pain and fever medication for use during pregnancy. It is preferred over alternatives like ibuprofen, which are not recommended, especially after 20 weeks of gestation due to known risks to the fetus.Acetaminophen in Pregnancy | ACOGFrequently Asked Questions about acetaminopheninpregnancy for health care professionals.Acetaminophen is still safe in pregnancy, despite controversy | Your Pregnancy Matters | UT Southwestern Medical CenterAccording to news reports, 66 cases ... taking acetaminophen (such as Tylenol) during pregnancy could cause autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in children. The lawsuit does not name any pharmaceutical manufacturers. Patients often ask about the safety of taking ...Can You Take Acetaminophen While Pregnant?Acetaminophen is an over-the-counter medication commonly used for pain relief and fevers. ... Yes, it is safe to use during your pregnancy. The 2024 study looked at thousands of siblings and compared pregnancies where mothers took acetaminophen during one but not the other.Read full articleSource: Cleveland ClinicTreating pain during pregnancy - PMCQUESTION My pregnant patients frequently ask about taking pain medications, sometimes for chronic conditions. What is known about the safety of using analgesics in therapeutic doses for acute or chronic painduringpregnancy? ANSWER Commonly ...
- Guideline Recommendations: Major organizations such as the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine continue to recommend acetaminophen as the first-line option for pain and fever during pregnancy, when used as needed and at the lowest effective dose for the shortest possible time.Acetaminophen in Pregnancy | ACOGFrequently Asked Questions about acetaminopheninpregnancy for health care professionals.ACOG Affirms Safety and Benefits of Acetaminophen during Pregnancy | ACOG"The data from numerous studies have shown that acetaminophen plays an important—and safe—role in the well-being of pregnant women."Can You Take Acetaminophen While Pregnant?Acetaminophen is an over-the-counter medication commonly used for pain relief and fevers. ... Yes, it is safe to use during your pregnancy. The 2024 study looked at thousands of siblings and compared pregnancies where mothers took acetaminophen during one but not the other.Read full articleSource: Cleveland ClinicAcetaminophen Use in Pregnancy and Neurodevelopmental Outcomes | ACOGBoth found no significant association ... outcomes once these confounders were considered. Untreated maternal conditions for which acetaminophen is indicated—such as fever, migraines and other headaches, and pain—can lead to significant maternal and fetal morbidity and mortality.
Research on Potential Risks
- Neurodevelopmental Disorders: Some studies have reported associations between frequent or prolonged acetaminophen use during pregnancy and a slightly increased risk of neurodevelopmental disorders in children, such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). However, these studies have limitations, and no causal relationship has been established.FDA Responds to Evidence of Possible Association Between Autism and Acetaminophen Use During Pregnancy | FDAEvidence in recent years has suggested a correlation between acetaminophen use duringpregnancy and subsequent diagnosis of conditions like autism and ADHD. Multiple large-scale cohort studies, including the Nurses’ Health Study II and the Boston Birth Cohort, find this association.Maternal use of acetaminophen during pregnancy and neurobehavioral problems in offspring at 3 years: A prospective cohort study - PMCAcetaminophen is one of the most commonly used drugs duringpregnancy globally. Recent studies have reported associations between prenatal exposure to acetaminophen and neurobehavioral problems in children, including attention-deficit hyperactivity ...Acetaminophen Use in Pregnancy and Neurodevelopmental Outcomes | ACOGBoth found no significant association ... outcomes once these confounders were considered. Untreated maternal conditions for which acetaminophen is indicated—such as fever, migraines and other headaches, and pain—can lead to significant maternal and fetal morbidity and mortality.Using acetaminophen during pregnancy may increase children’s autism and ADHD risk | Harvard T.H. Chan School of Public HealthWhen children are exposed to acetaminophen—also known by the brand name Tylenol or as paracetamol—duringpregnancy, they may be more likely to develop neurodevelopmental disorders including autism and ADHD, according to a new study.What the research says about autism and acetaminophen use during pregnancyPublished reports have previously raised concerns about a possible link between acetaminophen use duringpregnancy and an increased risk of developmental conditions such as autism spectrum disorder, but there are no studies that have established a causal link.Acetaminophen risk in pregnancy: What patients need to know | Your Pregnancy Matters | UT Southwestern Medical CenterSafety guidelines for taking pain medications such as Tylenol during pregnancy have not changed, despite recent research on acetaminophen risks. UT Southwestern discusses the news topic in the latest Your Pregnancy Matters blog.The relationship of prenatal acetaminophen exposure and attention-related behavior in early childhood - ScienceDirectAcetaminophen is currently the only analgesic considered safe for use throughout pregnancy, but recent studies indicate that prenatal exposure to acet…Read full articleSource: sciencedirect.comEvaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology - PMCHowever, population-level time ... with neurodevelopmental outcomes. Acetaminophen (also known as paracetamol) is currently considered the only pain and fever reducer indicated for use during pregnancy because of the risks of miscarriage or birth defects associated with other ...Is a common pain reliever safe during pregnancy? - Harvard HealthAccording to the consensus statement, some research suggests that exposure to acetaminophen during pregnancy — particularly high doses or frequent use — potentially increases risk for early puberty in girls, or male fertility problems such as low sperm count.Read full articleSource: Harvard HealthFrontiers | Association of Prenatal Acetaminophen Exposure Measured in Meconium With Adverse Birth Outcomes in a Canadian Birth CohortBackgroundThe small number of studies examining the association of prenatal acetaminophenwithbirthoutcomes have all relied on maternal self-report. It rem...Read full articleSource: FrontiersAcetaminophen in pregnancy and future risk of ADHD in offspring - PMCTwo high-quality cohort studies suggest an association between acetaminophen use in pregnancy and an increased risk of ADHD or similar behaviour in children. While cohort studies cannot prove causation, there might be a small risk with prolonged use of acetaminophen, especially in late pregnancy.Read full articleSource: ncbi.nlm.nih.gov
- The highest-quality studies to date have not found significant associations between acetaminophen use in pregnancy and increased risk of autism, ADHD, or intellectual disability in children.Acetaminophen in Pregnancy | ACOGFrequently Asked Questions about acetaminopheninpregnancy for health care professionals.ACOG Affirms Safety and Benefits of Acetaminophen during Pregnancy | ACOG"The data from numerous studies have shown that acetaminophen plays an important—and safe—role in the well-being of pregnant women."Can You Take Acetaminophen While Pregnant?Acetaminophen is an over-the-counter medication commonly used for pain relief and fevers. ... Yes, it is safe to use during your pregnancy. The 2024 study looked at thousands of siblings and compared pregnancies where mothers took acetaminophen during one but not the other.Read full articleSource: Cleveland ClinicAcetaminophen Use in Pregnancy and Neurodevelopmental Outcomes | ACOGBoth found no significant association ... outcomes once these confounders were considered. Untreated maternal conditions for which acetaminophen is indicated—such as fever, migraines and other headaches, and pain—can lead to significant maternal and fetal morbidity and mortality.
- Observed associations may be influenced by other factors, such as the underlying reason for acetaminophen use (e.g., infections, fever), genetics, or recall bias.Acetaminophen is still safe in pregnancy, despite controversy | Your Pregnancy Matters | UT Southwestern Medical CenterAccording to news reports, 66 cases ... taking acetaminophen (such as Tylenol) during pregnancy could cause autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in children. The lawsuit does not name any pharmaceutical manufacturers. Patients often ask about the safety of taking ...Frontiers | Association of Prenatal Acetaminophen Exposure Measured in Meconium With Adverse Birth Outcomes in a Canadian Birth CohortBackgroundThe small number of studies examining the association of prenatal acetaminophenwithbirthoutcomes have all relied on maternal self-report. It rem...Read full articleSource: FrontiersAcetaminophen in pregnancy and future risk of ADHD in offspring - PMCTwo high-quality cohort studies suggest an association between acetaminophen use in pregnancy and an increased risk of ADHD or similar behaviour in children. While cohort studies cannot prove causation, there might be a small risk with prolonged use of acetaminophen, especially in late pregnancy.Read full articleSource: ncbi.nlm.nih.gov
- The highest-quality studies to date have not found significant associations between acetaminophen use in pregnancy and increased risk of autism, ADHD, or intellectual disability in children.
- Other Birth Outcomes: Large studies have not found an increased risk of major birth defects or congenital abnormalities with acetaminophen use in pregnancy.Some studies suggest possible links to preterm birth or low birth weight, but these findings are not consistent and may be confounded by other factors.Acetaminophen (Paracetamol) - MotherToBaby | Fact Sheets - NCBI BookshelfThis sheet is about exposure to acetaminopheninpregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.Read full articleSource: ncbi.nlm.nih.govAcetaminophen use during pregnancy: effects on risk for congenital abnormalities - ScienceDirectWe evaluated if acetaminophen, one of the most frequently used drugs among pregnant women is associated with an increased prevalence of congenital abn…Read full articleSource: sciencedirect.comFrontiers | Association of Prenatal Acetaminophen Exposure Measured in Meconium With Adverse Birth Outcomes in a Canadian Birth CohortBackgroundThe small number of studies examining the association of prenatal acetaminophenwithbirthoutcomes have all relied on maternal self-report. It rem...Read full articleSource: FrontiersAcetaminophen (Paracetamol) - MotherToBaby | Fact Sheets - NCBI BookshelfThis sheet is about exposure to acetaminopheninpregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.Read full articleSource: ncbi.nlm.nih.govAssociation of Prenatal Acetaminophen Exposure Measured in Meconium With Adverse Birth Outcomes in a Canadian Birth Cohort - PubMedPrenatal acetaminophen was associated with adverse birthoutcomes. Although unobserved confounding and confounding by indication are possible, these results warrant further investigation into adverse perinatal effects of prenatal acetaminophen exposure.Read full articleSource: PubMed
When Acetaminophen May Be Necessary
- Fever and Pain Management: Untreated high fever during pregnancy can increase the risk of complications such as neural tube defects and preterm birth. In these cases, acetaminophen may be necessary and beneficial.ACOG Affirms Safety and Benefits of Acetaminophen during Pregnancy | ACOG"The data from numerous studies have shown that acetaminophen plays an important—and safe—role in the well-being of pregnant women."Is a common pain reliever safe during pregnancy? - Harvard HealthAccording to the consensus statement, some research suggests that exposure to acetaminophen during pregnancy — particularly high doses or frequent use — potentially increases risk for early puberty in girls, or male fertility problems such as low sperm count.Read full articleSource: Harvard HealthAcetaminophen Use in Pregnancy and Neurodevelopmental Outcomes | ACOGBoth found no significant association ... outcomes once these confounders were considered. Untreated maternal conditions for which acetaminophen is indicated—such as fever, migraines and other headaches, and pain—can lead to significant maternal and fetal morbidity and mortality.
- Alternatives: There are few alternatives for pain and fever relief that are considered safe throughout pregnancy. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are generally avoided due to risks to fetal development.Treating pain during pregnancy - PMCQUESTION My pregnant patients frequently ask about taking pain medications, sometimes for chronic conditions. What is known about the safety of using analgesics in therapeutic doses for acute or chronic painduringpregnancy? ANSWER Commonly ...Acetaminophen is still safe in pregnancy, despite controversy | Your Pregnancy Matters | UT Southwestern Medical CenterAccording to news reports, 66 cases ... taking acetaminophen (such as Tylenol) during pregnancy could cause autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in children. The lawsuit does not name any pharmaceutical manufacturers. Patients often ask about the safety of taking ...
Recommendations for Use
- Use the Lowest Effective Dose: Experts recommend using acetaminophen at the lowest effective dose and for the shortest duration needed to manage symptoms.Using acetaminophen during pregnancy may increase children’s autism and ADHD risk | Harvard T.H. Chan School of Public HealthWhen children are exposed to acetaminophen—also known by the brand name Tylenol or as paracetamol—duringpregnancy, they may be more likely to develop neurodevelopmental disorders including autism and ADHD, according to a new study.What the research says about autism and acetaminophen use during pregnancyPublished reports have previously raised concerns about a possible link between acetaminophen use duringpregnancy and an increased risk of developmental conditions such as autism spectrum disorder, but there are no studies that have established a causal link.Acetaminophen Use in Pregnancy and Neurodevelopmental Outcomes | ACOGBoth found no significant association ... outcomes once these confounders were considered. Untreated maternal conditions for which acetaminophen is indicated—such as fever, migraines and other headaches, and pain—can lead to significant maternal and fetal morbidity and mortality.Is a common pain reliever safe during pregnancy? - Harvard HealthAccording to the consensus statement, some research suggests that exposure to acetaminophen during pregnancy — particularly high doses or frequent use — potentially increases risk for early puberty in girls, or male fertility problems such as low sperm count.Read full articleSource: Harvard Health
- Consult Your Provider: If you need to use acetaminophen frequently or for an extended period, it’s recommended to discuss this with your OB/GYN or healthcare provider, who can work with you based on your specific medical history.ACOG Affirms Safety and Benefits of Acetaminophen during Pregnancy | ACOG"The data from numerous studies have shown that acetaminophen plays an important—and safe—role in the well-being of pregnant women."What the research says about autism and acetaminophen use during pregnancyPublished reports have previously raised concerns about a possible link between acetaminophen use duringpregnancy and an increased risk of developmental conditions such as autism spectrum disorder, but there are no studies that have established a causal link.Is a common pain reliever safe during pregnancy? - Harvard HealthAccording to the consensus statement, some research suggests that exposure to acetaminophen during pregnancy — particularly high doses or frequent use — potentially increases risk for early puberty in girls, or male fertility problems such as low sperm count.Read full articleSource: Harvard Health
Summary
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