Siouxland health officials say article advising against Acetaminophen during pregnancy is flawed

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SIOUX CITY, Iowa (KCAU) — Local health officials said a recent article recommending precautionary action to be taken against a common medication for pain is flawed. 

Scientists with Nature Reviews Endocrinology published an article in late September claiming there could be a correlation between the use of Acetaminophen (an ingredient in Tylenol and more than 600 other medications) and some birth defects. Some of their recommended course of action included forgoing the use of Acetaminophen during pregnancy unless medically indicated, using the lowest effective dose for the shortest possible time, and updated FDA recommendations.  

The study suggests prenatal exposure might be associated with reproductive and neurobehavioral abnormalities and an elevated risk of urogenital and reproductive tract abnormalities. 

Director of Maternal Fetal Medicine with UnityPoint Clinic, Al Fleming, said the article is flawed because it was conducted through observational studies rather than randomized controlled trials.  

“Before a pregnant patient takes any kind of medication, they should always talk to their provider about it,” Fleming said, “Both the American College of Obstetrics and Gynecology, and the Society for Maternal Fetal Medicine have not changed their recommendations for what is recommended in pregnancy and the safest medication is Acetaminophen or Tylenol for pain relief as directed.” 

Fleming said it is estimated that 50% of pregnant women will take Tylenol at some point during their pregnancy, but always as directed by an obstetrician or obstetrical provider. He also recommended looking at the ingredients of any over-the-counter medications before taking, because there are so many medications that have acetaminophen in them.  

“The study that is out has been recognized as flawed because it’s observation and the brain develops for 15 months after delivery and there’s other environmental exposures that a child could get in contact with,” Fleming said, “So, it’s hard to say that some random exposures to Tylenol during the course of a pregnancy could actually cause what are known to be multifactorial birth defects, urogenital type birth defects that occur.” 

Fleming said patients should understand that Tylenol has been used in pregnancy for a long time so it’s not feasible to say that there is cause and effect in relation to these abnormalities. He added that Acetaminophen or Tylenol continues to be the safest medication to use as directed for pregnant women.  

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