Society for Maternal-Fetal Medicine Statement: Acetaminophen use during pregnancy

Area of Science:

• Obstetrics and Gynecology
• Pediatric Neurology
• Pharmacology

Background:

• Acetaminophen is a widely used analgesic and antipyretic medication.
• Its safety during pregnancy has been a long-standing assumption.
• Emerging research questions potential links between prenatal acetaminophen exposure and child neurodevelopmental outcomes.

Purpose of the Study:

• To review the current evidence on the association between prenatal acetaminophen use and neurodevelopmental outcomes in children.
• To critically evaluate the findings of cohort studies and meta-analyses in this area.
• To provide guidance on the interpretation of these findings within the context of study limitations.

Main Methods:

• Systematic review and meta-analysis of observational studies.
• Analysis of cohort studies investigating prenatal acetaminophen exposure.
• Application of advanced statistical methods to mitigate bias.

Main Results:

• Some studies suggest a modest increase in the risk of neurodevelopmental disorders following prenatal acetaminophen exposure.
• Significant limitations inherent in observational studies, including potential confounding factors, affect the validity of these associations.
• Advanced statistical techniques may reduce but not eliminate bias from unmeasured or familial confounders.

Conclusions:

• Findings on prenatal acetaminophen and neurodevelopment require cautious interpretation due to study limitations.
• The Society for Maternal-Fetal Medicine reaffirms acetaminophen as the first-line treatment for pain and fever in pregnancy.
• Further research with robust methodologies is needed to clarify potential risks.