Is It Safe to Take Paracetamol During Pregnancy?

30 May, 2020
There were studies to evaluate the safety of the use of paracetamol during pregnancy. Thanks to these investigations, one can currently say that it's safe for pregnant women.
Taking paracetamol during pregnancy is a subject of much controversy and there are many conflicting opinions about it.
You may not be aware of it, but acetaminophen, an over-the-counter medication, is one of the best-selling drugs in the world. The problem is people are often unaware of its adverse effects and contraindications.
Until recently, the recommendations regarding the use of paracetamol during pregnancy indicated it was dangerous to use it. However, based on clinical experience, there’s no evidence of an association between the use of the drug and the impact on the urogenital system. There’s also none regarding alterations in the neurodevelopment of the child.

Paracetamol during pregnancy: Uses and effects

This widely used medication has analgesic and antipyretic properties. Thus, it reduces pain and fever. It’s similar to aspirin, except it neither reduces inflammation nor exerts an antiplatelet effect.
Due to these properties, people use paracetamol to reduce moderate, acute, and chronic pain. It’s the analgesic of choice by most doctors when it comes to patients over the age of 50.
Nobody knows exactly how paracetamol works, although we know it acts centrally. There’s a widely accepted hypothesis in the scientific community, though, that paracetamol increases the pain threshold by inhibiting cyclooxygenases. These are the molecules that participate in the synthesis of prostaglandins.
Prostaglandins are proteins related to pain. However, paracetamol isn’t capable of inhibiting cyclooxygenases at the peripheral level — outside the central nervous system. It’s for this reason that it has no anti-inflammatory activity. In addition, paracetamol also inhibits the synthesis and effects of various chemical mediators that sensitize pain receptors to mechanical or chemical stimuli.
As for its effectiveness in reducing febrile symptoms, paracetamol is capable of blocking the brain area that controls body temperature. Therefore, it manages to dissipate heat by triggering vasodilation and increasing peripheral blood flow and sweating.
Is Paracetamol safe during pregnancy?
Acetaminophen is an over-the-counter medication; thus, it’s widely used.
You may also be interested in reading: Non-Acid Non-Opioid Analgesics

Adverse reactions of paracetamol

Paracetamol is hepatotoxic (toxic to the liver). However, in most cases this toxicity is the result of either an overdose or chronically administered excessive doses. Paracetamol-induced hepatotoxicity manifests as:
  • Liver necrosis
  • Jaundice, that is a yellow discoloration of the skin and mucous membranes
  • Digestive bleeding or skin bruising
  • Encephalopathy
In addition to this toxicity, it can also produce other side effects such as:
  • Neutropenia (decreased white blood cells)
  • Urticaria and other allergic reactions

Recommendations on the use of paracetamol during pregnancy

A woman about to take a pill.
The Spanish Ministry of Health recently changed the recommendations for the use of paracetamol during pregnancy. When a company markets a drug, it must conduct a series of observational studies to assess its long-term safety. This is also to detect hazards not yet assessed during the previous study phases.
During this periodic evaluation of paracetamol by the pharmacovigilance departments, they’ve also investigated more about the danger it poses to the fetus of any pregnant women who take paracetamol. All the new safety data for this medication generated via observational studies are now in the technical datasheet. They’re also listed in the medication package inserts that contain this active ingredient.
As you can see, the AEMPS has a solid basis to give a verdict. After carrying out all the corresponding reviews, they concluded that there’s no evidence that the prenatal use of paracetamol has neither an impact on the urogenital apparatus nor leads to neurodevelopmental disorders in a child.

Conclusion

In short, a pregnant woman can take paracetamol under a doctor’s supervision and as long as they don’t abuse it. Pregnant women must be cautious when using medications and avoiding self-medicating under any circumstances. 
When in doubt, always follow the advice of your doctor.
  • Farré, M., Abanades, S., Álvarez, Y., Barral, D., & Roset, P. N. (2004). Paracetamol. DOLOR. https://doi.org/10.12968/jprp.2019.1.1.7
  • Graham, G. G., Davies, M. J., Day, R. O., Mohamudally, A., & Scott, K. F. (2013). The modern pharmacology of paracetamol: Therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings. Inflammopharmacology. https://doi.org/10.1007/s10787-013-0172-x
  • Eyers, S., Weatherall, M., Jefferies, S., & Beasley, R. (2011). Paracetamol in pregnancy and the risk of wheezing in offspring: A systematic review and meta-analysis. Clinical and Experimental Allergy. https://doi.org/10.1111/j.1365-2222.2010.03691.x