New Pregnancy Drug Risk: Acetaminophen and Language Delays

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We all know that when we become pregnant, we have to limit ourselves in some regards. We shouldn’t lift very heavy objects or drive a vehicle if we become too uncomfortable, and we must make sure to avoid certain foods, like shellfish, soft cheeses, and alcohol. Many types of medicines, including ones we may not think twice about taking on a normal day, also are off limits — and for good reason. They may harm a developing fetus.

Acetaminophen, for example, may cause behavioral problems in children. Now, a new study has found that this common over-the-counter drug may additionally cause serious language delays in girls — even if their mother just took a few doses while pregnant.

The Dangers of Acetaminophen While Pregnant

While we’ve previously covered how acetaminophen may cause hyperactivity and emotional problems in children, this new research offers all the more reason to stay away from dangerous (or seemingly not-so-dangerous) drugs while pregnant — even if they are generally safe when taken correctly while we’re not with child.

Language ability is related to both attention and behavior when we’re young and still learning, so it makes sense that recent studies on acetaminophen and their results would be linked. Language delays also can greatly affect a child’s academic performance, which may result in long-term consequences if not addressed.

In the latest study, published in European Psychiatry, 700 Swedish women and their children were analyzed. Girls who were born to mothers who had taken more than six tablets of acetaminophen during their whole pregnancy were almost six times as likely to have language problems than women who didn’t take acetaminophen while pregnant. Those children spoke fewer than 50 words by the time the were 2.5 years old.

It’s not clear how this happens or why. Part of it may be related to hormonal changes. Of course, not every pregnant woman who takes acetaminophen will find problems with their child later on, and some developmental delays may be the result of genetic or other factors.

Unfortunately, acetaminophen use is still common in pregnancies, despite these warnings. About 50% of women today may be using acetaminophen while pregnant.

Uses and Side Effects of Acetaminophen

Acetaminophen isn’t popular just during pregnancy. Even more people take acetaminophen regularly to relieve headaches, reduce fevers, help with muscle aches and cramps, and more. It’s a type of analgesic, or pain reliever, as well as an antipyretic, or fever reducer, and can be found in lots of cold and flu medicines. When combined with caffeine, it helps relieve migraines.

Side effects of acetaminophen can include a rash, hives, itching, or swelling; difficulty breathing or swallowing; or red and blistering skin. In addition to dulling pain, one study also found that acetaminophen may affect even adults’ emotions: by dulling our empathy.

It’s also possible to overdose on acetaminophen. Hundreds of people die from an acetaminophen overdose each year; the drug is the most dangerous of all over-the-counter medications, according to the American Association of Poison Control Centers. Symptoms of an overdose include nausea, vomiting, loss of appetite and fatigue, unusual bleeding or bruising, sweating, yellowing of the skin or eyes, pain in the upper right part of the stomach, and flu-like symptoms.

Aside from pregnant women — or women who are trying to conceive — there are other people who shouldn’t take acetaminophen at all:

• If you are allergic;
• If you take other certain medications, such as blood thinners or medications for seizures;
• If you’ve ever developed a rash while taking acetaminophen;
• If you are a heavy drinker (three or more alcoholic beverages per day);
• If you are a child younger than age 2 (any other cough/cold products should be used carefully in children ages 2-11);
• If you have phenylketonuria (PKU), in which some chewable acetaminophen tablets may be sweetened with aspartame and dangerous to those with this inherited condition.

When breastfeeding, usually just aspirin and antibiotics are off the table, but you should speak with your doctor to be sure.

See also: Reye’s Syndrome and Aspirin in Children: Know the Risks

Other Problems with Drugs and Pregnancy

One benefit of acetaminophen, in certain situations, is that it only reduces pain and fever symptoms. It isn’t an anti-inflammatory. Although taking too much acetaminophen can damage our livers, NSAIDS, or nonsteroidal anti-inflammatory drugs, also aren’t great for us. They irritate the stomach and intestinal lining.

The U.S. Food and Drug Administration (FDA) notes that while research remains limited, any over-the-counter drug (OTC) use during pregnancy should be “carefully considered”:

“Severe and persistent pain that is not effectively treated during pregnancy can result in depression, anxiety, and high blood pressure in the mother. Medicines including nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminophen can help treat severe and persistent pain. However, it is important to carefully weigh the benefits and risks of using prescription and OTC pain medicines during pregnancy.”

It’s also important to note that fewer than 10% of FDA-approved medications have enough information to determine the risk of any birth defects, according to the Centers for Disease Control and Prevention.

Risks of other OTC and prescription drug use while pregnant include:

• Women may be more likely to miscarry in the first half of their pregnancy if they use prescription NSAIDS, including ibuprofen, naproxen, diclofenac, and celecoxib.
• Opioids (oxycodone, hydrocodone, hydromorphone, morphine, and codeine) may increase the risk of birth defects of the brain, spine, or spinal cord.
• Acetaminophen can increase the risk of attention deficit hyperactivity disorder in children.

It should also go without saying that any illicit drug use during pregnancy and while breastfeeding can have severe harmful effects on baby, though the debate over marijuana use in pregnancy rages on. Alcohol and tobacco also should be avoided.

Alternatives to Over-the-Counter Medicine During Pregnancy

So, what if you have a headache, a fever — or heaven forbid, the flu — while pregnant? What should you do?

Some complementary and alternative medicine may be safe during pregnancy, but it’s best to avoid any unnecessary medications or treatment while pregnant, as best you can. That said, you may want to speak more to your OB/GYN about the following therapies if you are experiencing any pain while pregnant:

• Massage or aromatherapy, which may help with anxiety
• Acupuncture for back or pelvic pain, or alleviating depression
• Acupressure, vitamin B6, and ginger for morning sickness

Bottom line, before reaching for the medicine cabinet or setting an appointment with a massage therapist, contact your doctor. Do not start or stop any medications or pain treatment methods before speaking with your healthcare provider. He or she will be able to guide you best on what is safe to take while pregnant, and you’ll want to keep them updated on any medications you took before pregnant or plan to continue taking while pregnant or after birth.

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