Tylenol May Not Be As ‘Safe’ a Pain Reliever During Pregnancy As You May Think

A new study suggests taking acetaminophen, especially during the 2nd and 3rd trimesters, could lead to speech delays in children.

Fact checked by Sarah Scott

For pregnant people, Acetaminophen has long been considered safe to use to reduce fever and alleviate pain. But there's a new study that calls this all into question.

The Illinois Kids Development Study recently conducted research that examined the relationship between acetaminophen (brand name, Tylenol) use during pregnancy and early language development. Megan Woodbury, PhD, a postdoctoral research associate at Northeastern University who helped conduct the study explains what they found.

“Taking more acetaminophen during pregnancy, especially during the third trimester, was associated with children having smaller vocabularies and speaking in shorter sentences at age 2,” Dr. Woodbury explains.

At age 3, children showed lower scores on the Speech and Language Assessment Scale. Researchers also found that increased acetaminophen use during the third trimester led to increased odds of scores under the 25th percentile in boys when it came to speaking in shorter sentences.

While this is important information for expectant parents or those who want to become pregnant, it does not mean you should stop taking acetaminophen or worry if you did take acetaminophen while pregnant that your baby’s language development is at risk.

“High fever or severe pain can also negatively impact fetal development,” explains Dr. Woodbury. “It’s why acetaminophen can and should be taken as needed during pregnancy—but perhaps reconsider taking it just for minor aches and pains.”

Limitations of the Study

The study's authors do acknowledge there are some limitations. Just one example was the participation was "relatively homogenous," meaning the subjects were largely White, non-Hispanic, well-educated, and with a high annual income. In addition, there is always a risk for inaccurate reporting by the subjects.

Still, researchers say their findings "suggest that the impact of acetaminophen use during pregnancy on child neurodevelopment should be further investigated."

Alicia Robbins, MD, a double board-certified gynecologist and founder of The Elm in Connecticut points out that the results are from an observational study which means there could be many confounding variables.

“For example, maybe the women had other meds they were taking. Also, the follow-up required parents to answer surveys about their kids. Surveys—especially about our own children—are known to be really hard to standardize and can be full of recall memory bias or inaccuracies,” she explains. “Interesting to point out, it said the male kids had more speech delays, but I think it’s possible that this may be a normal milestone that boys reach later.”

Dr. Robbins says she's never had a patient report that they suspected their baby’s speech delay was a result of taking acetaminophen during pregnancy. “Acetaminophen has been used so much in pregnancy that I honestly think we would be seeing more obvious issues if there was a real issue.”

Donna Adams-Pickett, PhD, MD, a board-certified OB/GYN agrees. “There’s a phrase we use in medicine, 'association does not equal causation.’  While there is a possibility that the use of acetaminophen could have played a role in the minor speech delays seen, there are also several other genetic, biological, and socioeconomic factors that could have contributed to those outcomes as well,” she explains.

Should I Stop Taking Tylenol if I'm Pregnant?

Dr. Robbins says she has always allowed her patients to take acetaminophen.

“It’s been around a long time and can be very helpful in a situation where a pregnant [person] has a fever. Fevers in pregnancy can cause mothers and babies to become ill quickly and I think it is totally appropriate to take acetaminophen in that situation,” she says. “I don't usually recommend acetaminophen for pain but that's because I just don't think it works well for pain.”

If you do experience pain in the third trimester, Dr. Robbins recommends warm showers or baths to relax the uterus since it’s a muscle. And, for joint and back pain, she believes yoga and acupuncture are helpful. 

Dr. Woodbury emphasizes that the findings of the Illinois Kids Development Study do not mean acetaminophen definitely causes language delay or autism. To date, scientific research has not been able to pinpoint a single cause of either.

Still, Dr. Woodbury believes it’s important to be mindful of how much acetaminophen is taken during pregnancy. It's found in more than 600 over-the-counter (OTC) and prescription medications, and taking too much can cause liver damage and even death—whether you’re pregnant or not.

“KnowYourDose.org has lists of common OTC and prescription medications which contain acetaminophen, Mother to Baby has a great fact sheet about acetaminophen use during pregnancy and breastfeeding, and the US Food and Drug Administration (FDA) also has helpful resources,” recommends Dr. Woobury. 

No matter what, Dr. Adams-Pickett says taking OTC medications during pregnancy should be done under the supervision and direction of a physician.

“Only your doctor or midwife knows the nuances of your individual pregnancy. Medications safe for a friend or colleague may not be safe for you depending on your health history and specifics of your pregnancy,” she explains. As a rule of thumb, always seek advice from your medical team before taking any medication.

For more Parents news, make sure to sign up for our newsletter!

Read the original article on Parents.