ADHD, Acetaminophen, and Pregnancy

It can be a scary thing to not feel well when you’re pregnant because you don’t want to subject the baby to anything that could possibly do harm.  But chances are if you have an infection or fever, your doctor won’t hesitate to recommend Tylenol.  Women have been taking medications containing its active ingredient, acetaminophen, for decades without a problem…unless you choose to count the occasional case of liver failure.  But now it appears that it actually might cause a problem for the baby, just not one that is obvious at birth.  New research has found that the use of acetaminophen during pregnancy may be strongly associated with the development of attention-deficit hyperactivity disorder in children.

The study, which was conducted at the University of Aarhus in Denmark, determined that when a mother-to-be takes acetaminophen, the baby she is carrying faces a greater risk of having ADHD a few years later.¹ Healy, Melissa. “Acetaminophen in pregnancy linked to ADHD in kids, study finds.” Los Angeles Times. 24 February 2014. Accessed 2 March 2014. http://www.latimes.com/science/la-sci-tylenol-pregnancy-20140225,0,3832225.story#axzz2ufGbZpiZ   The subjects were more than 64,000 Danish women and their kids.  They were followed by the scientists for a period beginning at their pregnancy’s first trimester and continuing for as long as 15 years.  As each trimester ended, the participants were asked questions about their recent use of acetaminophen.

All of the parents completed regular surveys focused on how their children were generally behaving.  Plus, the researchers analyzed extensive data from medical registries in Denmark that included information on both the diagnoses that had been made and the prescription medications that had been obtained through a pharmacy.  Once compiled, this evidence pointed to the fact that those children whose mothers had taken acetaminophen during any portion of their pregnancy had a 29 percent greater likelihood of having an ADHD diagnosis as compared to their peers whose mothers had not used the medicine at all during pregnancy.

The timing of the acetaminophen use appears to be important as well.  When it was used only during the first trimester, the increased risk of ADHD was nine percent. When it was used only in the third trimester, the risk rose by 28 percent.  However, in those cases in which acetaminophen had been taken in both the second and third trimesters, the chances of the child developing ADHD grew by a stunning 63 percent.

And Tylenol is not the only source of acetaminophen by a long shot.  This painkiller can be found in Excedrin, many generic analgesics, cough medicines, and a wide range of multi-symptom cold formulas.  In most of the world outside North America, this drug is called paracetamol and it is used in similar types of products.

This study does seem to demonstrate that acetaminophen may have a substantial impact on a fetus’s developing brain, particularly after the first trimester of pregnancy.  Since quantities or frequency of acetaminophen use by the mothers-to-be was not reported, it is difficult to know whether any level of the medication could be considered safe during pregnancy.  But it’s most likely a smart move to err on the side of caution, especially since this is not the first research that has found potential damage acetaminophen may cause to babies in utero.  A study performed at the University of Oslo in Norway in 2013 discovered that when women used acetaminophen during pregnancy, their babies had a higher rate of developmental issues involving communication, motor development, and behavioral problems when compared to a sibling born after a pregnancy in which no acetaminophen was taken.² Brandlistuen, RE; et al. “Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled cohort study.” International Journal of Epidemiology. 24 October 2013. Accessed 3 March 2014. http://www.ncbi.nlm.nih.gov/pubmed/24163279 And beyond the brain, it’s use by babies has been linked to childhood asthma, eczema, and eye and nose problems.

Even with this growing body of evidence, many physicians will still likely recommend a pregnant woman take acetaminophen if faced with an infection, rationalizing that the fever may be more likely to harm the fetus than the drug will–or more likely, simply not being aware there might be a problem. Your best bet, obviously, is to do whatever you can to stay healthy during pregnancy. Bolster your immune system with natural supplements before you even start trying to conceive.  Then, once you are carrying, wash your hands regularly with soap and water, get plenty of sleep, eat a nutritious diet, and continue exercising. Taking good care of yourself and staying well may be all the ammunition you need to have an easy pregnancy and give birth to a healthy bundle of joy.