American and European doctors have published a consensus statement in the journal Nature calling the caution in the use of paracetamol in pregnant women, since of a growth of certain neurodevelopmental, reproductive or behavioral problems in newborns.
The text, prepared by 13 health professionals, is also supported by another 78 clinical or scientific base experts, among which are neurologists, gynecologists, pediatricians and researchers in toxicology or endocrinology.
The authors have reviewed more than a hundred studies, both epidemiologically and experimentally, published between 1995 and 2020. Thus, they warn of a association between paracetamol consumption in pregnancy and increased risk of cryptorchidism (testicles that do not descend to the scrotum) or the distance between the anus and the base of the penis (anogenital distance) in boys.
A potential relationship has also been found with early development of female puberty or increased risk of attention deficit hyperactivity disorder (ADHD) or the autism spectrum, as well as delays in language development in girls and a lower IQ. In animal studies, other abnormalities such as a decrease in the number of sperm and eggs have also been found.
Paracetamol is one of the most popular drugs and the most prescribed for pregnant women. There are more than 600 different treatments that include it to treat mild to moderate pain and reduce fever. Due to its safety profile, it is usually preferred over other drugs such as non-steroidal anti-inflammatory drugs (ibuprofen).
That does not mean, of course, that it is harmless. In fact, the Spanish Agency for Medicines and Health Products advises that you should consult your doctor about its use “if you are pregnant or think you might be pregnant or intend to become pregnant.” It also recommends that the lowest possible dose be used for the shortest possible time.
A recent study carried out by the Neonatology and Obstetrics units of the Hospital La Paz in Madrid concluded, after a survey of 900 pregnant women, that 67% had consumed paracetamol during pregnancy, a slightly higher proportion than that registered in previous studies.
The most frequent reason for its consumption was headache and most took it at the recommended therapeutic dose, that is, a maximum of 4 grams per day. Of them, 45.7% took it for three days in a row or less. In general, one in five pregnant women took paracetamol throughout their pregnancy (this does not mean that they took it often, but in all its phases).
The consensus document published in Nature calls for greater proactivity on the part of health professionals to report the potential effects of the drug. In fact, the La Paz research indicates that only 51.9% of pregnant women had received information on this and, in 74% of the cases, this indicated that its consumption did not associate risks for the fetus.
The signatories of the consensus also call for increased research focused on its effects, as there are many unknowns to clarify. For example, the amount of the active ingredient that can be considered dangerous for the fetus has not been determined, remaining in the general recommendation of “lower effective dose for the shortest possible time”.
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