Acetaminophen is generally considered safe for women to continue taking while they are pregnant or nursing. New research suggests that fetal exposure to the drug may be associated with behavioral problems such as ADHD or other disorders in children.
JAMA Pediatrics published a study on February 24 that assessed the relation between acetaminophen use during pregnancy and the number of children that were at risk for developing ADHD or Hyperkinetic Disorders from 1996-2002. The mothers involved in the study participated in two phone interviews during the research, and another follow-up six months after their child’s birth. When a child who was participating in the study reached the age of 7, a parent or caregiver completed the Strengths and Difficulties Questionnaire to assess ADHD or Hyperkinetic behaviors that were present in the child. 56% of the women involved in the study reported using acetaminophen while pregnant. The results of the research indicated that children that were exposed to acetaminophen were at a 50% increased risk for developing ADHD requiring medication if their mother took acetaminophen for over 20 weeks during pregnancy.
Though the study results may seem alarming, the authors of an accompanying editorial in the JAMA Pediatrics note that these findings do not prove a direct cause-and-effect relationship between those women who used acetaminophen during pregnancy and those that did not. Acetaminophen is commonly used during pregnancy, and the editorial suggests that, given the high number of children diagnosed with ADHD annually, more research is needed. This research provides a platform for which further studies can be done on fetal brain development and acetaminophen use.
Pharmacists can help their patients who are expecting a child to choose an over the counter pain medication that will not have adverse effects on fetal development. Some patients may still opt to take acetaminophen, and pharmacists should help patients ensure that they follow medication regimes and do not take more than the daily recommended amount of medication.
Ensuring that patients are able to manage their pain during a healthy pregnancy is crucial. A common problem for pregnant women is swelling of the feet or ankles, which can be treated with a low dose of acetaminophen and elevation of the feet. Helping patients who are pregnant manage their pain safely can be done by educating patients and ensuring that they are aware of the variety of non-medication pain relief that exists. Hot and cold compresses, elevation, massage, and acupuncture can all help to alleviate pain that a pregnant mother may be experiencing. Pharmacists can help patients to establish their levels of pain, and offer alternatives to medication. Pharmacists can connect with their community and help to ensure that families remain healthy during and after pregnancy by offering alternatives to acetaminophen, and helping patients that choose to take acetaminophen understand its dosage schedule.