April 4, 2023 Pregnancy is an exciting time, but it’s also a physically challenging time for the many women plagued by aches and pains often experienced by expectant mothers. From abdominal cramping to ligament pain to headaches, there’s no question that pregnancy can exact a toll on a woman’s body.
That’s why it isn’t uncommon for moms-to-be to turn to over-the-counter painkillers to cope with the physical woes that often go hand-in-hand with being pregnant. In fact, eight out of 10 pregnant women take common drugs like paracetamol, ibuprofen, or aspirin to manage their aches and pains. But taking these easily accessible medications can end up harming the baby, according to experts.
How Can NSAIDs Harm Babies?
According to a study from the Centers for Disease Control and Prevention (CDC), women in the early stages of pregnancy who took NSAIDs – nonsteroidal anti-inflammatory drugs, a class that includes aspirin and ibuprofen – were more likely to have babies who had certain birth defects.
NSAIDs used during early pregnancy may be related to birth defects such as:
- Gastroschisis, a birth defect where a hole in the abdominal wall beside the belly button allows the baby’s intestines to extend outside of the baby’s body.
- Cleft palate, which occurs when a baby’s lip or mouth does not form properly during pregnancy.
- Spina bifida, a condition that affects the spine when the neural tube does not close all the way. This often results in damage to the spinal cord and nerves.
- Congenital heart defects, which can affect the structure of a baby’s heart and the way it works.
Some NSAIDs taken during the later stages of pregnancy have also been associated with an increased risk to babies. Naproxen, which is commonly used to relieve pain and temporarily reduce fever, is not recommended for use after week 20 of a pregnancy. There have been reports that using NSAIDs during the second half of pregnancy may affect a baby’s developing kidneys. When used later in pregnancy, naproxen may also cause premature closure of a vessel that runs from the pulmonary artery to the aorta; premature closure of this blood vessel can cause high blood pressure in the lungs of a fetus.
In October 2020, the U.S. Food and Drug Administration (FDA) recommended avoiding the use of NSAIDs after the 20th week of pregnancy, unless recommended by a healthcare provider.
How Can Paracetamol Harm Babies?
Paracetamol – known as acetaminophen outside the U.S. – has been linked to an increased risk of some neurodevelopmental, reproductive and urogenital disorders in developing fetuses. Studies have also shown a link between fetal exposure to paracetamol and neurodevelopmental outcomes such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, language delays, decreased IQ, and conduct disorders.
An international group of doctors and scientists released a consensus statement in Nature Reviews Endocrinology, a peer-reviewed medical journal, calling for pregnant women to be cautioned about forgoing use of paracetamol during pregnancy unless it is “medically indicated.” In the statement, the group referenced growing evidence of paracetamol’s potential to interfere with fetal development. The group based their recommendations on a review of 29 studies that involved the use of acetaminophen, of which 26 found evidence of birth defects.
The authors of the study also included recommendations for U.S. and European regulatory bodies, including:
- Having labels on acetaminophen (and any drugs containing acetaminophen) that include recommendations for use during pregnancy
- Conducting new safety reviews of the drug and updating recommendations as needed
- Conducting additional studies that examine the use of acetaminophen (and drugs containing acetaminophen) to more accurately determine if and how the drugs should be dosed, and for how long, during pregnancy
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