Changes in the pattern of paracetamol use in the periconception period in a Danish cohort

Area of Science:

• Obstetrics and Gynecology
• Pharmacology
• Public Health

Background:

• Paracetamol (acetaminophen) is a widely used over-the-counter medication during pregnancy.
• While generally considered safe, prolonged antenatal exposure is linked to potential offspring morbidity.
• Understanding usage patterns, especially frequent use, is crucial for maternal and child health.

Purpose of the Study:

• To characterize paracetamol (acetaminophen) consumption patterns in pregnant women.
• To identify factors associated with frequent paracetamol use (more than once weekly) before and during early pregnancy.
• To evaluate the impact of legislation restricting large pack access on paracetamol usage.

Main Methods:

• A web-based clinical questionnaire administered to 8650 pregnant women.
• Data collected on drug use, including paracetamol, in the 3 months prior to and during early pregnancy.
• Statistical analysis to identify associations between frequent paracetamol use and demographic/clinical factors.

Main Results:

• Paracetamol was the most frequently used drug, with 35.2% use before pregnancy and 6.5% during early pregnancy.
• The proportion of frequent paracetamol users decreased from 3.9% pre-pregnancy to 0.9% in early pregnancy.
• Frequent use was associated with smoking, comorbidities, higher BMI, unplanned pregnancy, lower education, and language barriers. Legislation restricting large pack access correlated with a decrease in overall paracetamol use.

Conclusions:

• Paracetamol is commonly used by pregnant women, but frequent use is less common and associated with specific risk factors.
• Legislation limiting access to large paracetamol packs may reduce overall usage during pregnancy.
• Further research into the specific risks of frequent antenatal paracetamol exposure is warranted.