UNIVERSITY PARK, Pa. — It’s no secret that pregnant women should avoid alcohol and cigarettes for the health of their baby. Some pregnancy symptoms such as back pain or headaches may make mothers want to take a Tylenol. Now, researchers from Penn State say it may be a good idea to stay away from Tylenol as well. Study authors report taking acetaminophen while expecting may lead to sleep and behavioral issues in children that are consistent with attention deficit hyperactivity disorder (ADHD).
Sold under a number of different names, acetaminophen is generally a mild drug which treats pain, fever, headaches, infections, colds, or allergies. Historically, doctors have considered the drug safe to take while pregnant for quite some time. Recent research, however, is starting to suggest that acetaminophen may affect child development and may have a connection to attention problems.
This latest research project appears to support those earlier preliminary findings. Study authors say their work is the first ever to observe a clear association between acetaminophen use while pregnant and subsequent child sleep challenges.
“Pregnant people experience pain, fever and other ailments that could be alleviated through the use of acetaminophen,” says lead study author Kristin Sznajder, an assistant professor of public health sciences, in a university release. “While the medication may provide relief in the moment, research increasingly indicates there may be downstream effects that could be detrimental to child development. More research is needed so appropriate recommendations can be made to pregnant people.”
4 in 10 pregnant women use mild pain relievers
The researcher team utilized data originally collected for a study of over 2,400 pregnant women who had never given birth. That prior study tracked those women and their children from the third trimester of pregnancy to three years postpartum. Participants completed surveys while pregnant regarding their medication use and frequency and stress levels. In all, 41.7 percent of women reported using acetaminophen during pregnancy.
Next, researchers interviewed the mothers multiple times after giving birth — one, six, 12, 18, 24, 30, and 36 months after their child was born. During the last interview, participants had to rate their child using a three-point scale describing how often they exhibit various neurodevelopmental and behavioral outcomes (very often true, somewhat or sometimes true, or not true). Examples include “can’t sit still or restless,” “avoids looking others in the eyes,” and “doesn’t want to sleep alone.” Scientists then combined the scores for each behavior to help determine if each child scored high in categories such as emotionally reactive, anxious or depressed, withdrawn, sleep problems, and aggressive behavior.
Using responses from the 99-item Child Behavior Checklist, the research team then evaluated if children born to mothers who used acetaminophen during pregnancy were more likely to have attention, sleep, or other neurobehavioral issues. Since women who used acetaminophen while pregnant were more likely to deal with depression or anxiety before becoming pregnant and were also more likely to report high levels of stress during pregnancy, researchers decided to account for stress, depression during pregnancy, and previous diagnoses of depression or anxiety during their statistical analyses.
Even after accounting for those confounding variables, children born to women who used acetaminophen were still significantly more likely to deal with sleep issues and attention problems than other children. More specifically, 22.7 percent of participants who used acetaminophen while pregnant said their child had sleep issues. Another 32.9 percent described their children as having attention problems. Conversely, among women who did not take acetaminophen while pregnant, only 18.9 percent said their child had trouble sleeping and 28 percent noticed attention problems.
Could pregnancy trimester be a factor?
Study authors say more research is necessary to totally understand the relationship between acetaminophen use while pregnant and behavioral outcomes among offspring. For instance, survey responses used for this project lacked data on the trimester of use, frequency of use, and dosage amount. Prof. Sznajder notes another study is already underway focusing on how the trimester, frequency, and dosage may influence behavioral offspring outcomes.
Right now, the research team can’t say what prenatal development processes prenatal acetaminophen use may be disrupting. However, a few possibilities include acetaminophen damaging the placenta, consequently disrupting fetal development, or acetaminophen damaging fetal liver cells, disrupting gut health, and influencing neurodevelopment.
“We should interpret these results with some degree of caution,” Prof. Sznajder concludes. “Although acetaminophen is generally considered safe for use during pregnancy, data from multiple studies suggest that there could be effects on childhood development by its use. It’s important we learn as much as we can about this subject so we can give expecting mothers data-driven recommendations to care for their children and themselves.”
The findings appear in PLOS One.