During both my pregnancies I did almost everything right. I ate well, doing things like avoiding raw meats and sushi and eating lots of fruits and veggies; took really good prenatal vitamins; exercised, but not too much; didn’t take a sip of alcohol or smoke a cigarette or expose myself to harmful chemicals. And before I took any medication, I either contacted my OB-GYN for approval or did thorough online research to check if it was on the safe list.
One thing I did do while pregnant with both my son and daughter was take Tylenol, pretty much daily. I have chronic back pain, which was made worse by the extra weight I was carrying around. During those pregnancies, I saw several doctors (between moving across the country and using large practices that require you to rotate between the different MDs), and every single one of them gave me the go-ahead when it came to using acetaminophen. “It’s totally safe,” I was assured. “Just only take it as directed.”
Both my pregnancies were healthy and my children, now almost 3 years old and 7 months old, are absolutely perfect. I think. But according to research published in JAMA Pediatrics this week, there’s a chance that in the near future, they will not be.
The study, conducted by researchers at The University of Bristol, concludes that women who take acetaminophen, also known as paracetamol, during pregnancy are more likely to have children with behavioral issues and hyperactivity.
The headlines I was reading from news outlets around the country jolted me into the same range of emotions that most mothers experience every time one of these startling new studies is released.
Shock. Anxiety. Fear. Frustration. Guilt. Anger. Confusion.
I feel like a horrible mother. How could I do this to my children? I quite possibly, but unknowingly, inflicted them with a lifetime of behavioral issues. Was my son already demonstrating signs of ADHD? I thought about the way he’s been acting recently and the attention issues he’s having. “He’s a toddler,” my pediatrician, friends, and family members assured me when I voiced my concerns. “He’s totally normal.”
But what if he wasn’t. And what if I did it to him?
I decided to check out what other mothers were saying about the study on social media, and while many appeared to be feeling the same way as I, the perfect parent police were also out in full force. They didn’t take any drugs during their pregnancy, after all, because they didn’t want to put their baby’s life in danger.
Well I didn’t either.
I tried reading the study myself, instead of relying on another news source to decipher its meaning, and along with the help of my mother-in-law, who worked in the pharmaceutical industry for several years, as well a few of my doctor friends, I am choosing not to freak out about this.
The University of Bristol study used data collected and analyzed from ALSPAC and studied 7,796 mothers who were enrolled in the program between 1991 and 1992. They found that 4,415 women (53%) reported using the drug at 18 weeks of pregnancy, while only 3,381 (42%) at 32 weeks. Of all the women surveyed, only 5% of their children displayed any behavioral problems by age 7.
After looking at other factors — such as smoking and alcohol use, socioeconomics and genetics — they determined that using the drug at 18 weeks was associated with a high risk of hyperactivity, and 32 weeks with having emotional symptoms, conduct problems, and hyperactivity symptoms.
Nowhere in the study does it include information on the dosage or duration of use for any of the women, because these women were “not asked detailed questions on dose or duration or indications of use,” nor did it ask these women the important question of why they were taking it.
NPR’s Richard Harris also points out that the women who did take it were “more likely to report that they smoked during their pregnancies, that they drank alcohol, and that they suffered from psychiatric illness” and “when the researchers mathematically factored out those confounding observations, the effect disappeared entirely for some subgroups and was diminished in the others.” While the study reports that these behavioral problems are about 20 to 45 percent more common in women who took the drug during pregnancy, he also draws attention to the fact that “you have to dig into the supplementary data tales posted online.”
For example, of all the women tested who did not take the drug, 4.3 percent of their children had an elevated score on the SDQ total difficulties test (the questionnaire they were using to measure said behavioral issues) compared to 6.3 percent of children born to women who did take the drug.
Statistically, not quite so scary, right?
“Given the widespread use of acetaminophen among pregnant women, this can have important implications on public health,” the study concludes. “However, the risk of not treating fever or pain during pregnancy should be carefully weighted against any potential harm of acetaminophen to the offspring.”
In fact, Dr. Evie Stergiakouli, the lead author of the study, admitted to ABC that “this does not mean it is not safe to take during pregnancy.”
While I am curious to see what further testing reveals, I am going to try to avoid losing sleep over the minuscule chance that I inflicted behavioral problems on my child.
Relief. The (usual) final emotion in the series I go through every time a new study is released.