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Scandinavian Journal of Pain

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Is acetaminophen safe in pregnancy?

Katsuhiro Toda
  • Corresponding author
  • Department of Orthopedic Surgery, Kitahiroshima Town Toyohira Hospital, 4705 Azaka, Kitahiroshima Town, 731-1222, Yamagata-Gun, Hiroshima, Japan
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Published Online: 2017-12-29 | DOI: https://doi.org/10.1016/j.sjpain.2017.09.007

Graphical Abstract


Acetaminophen is thought to be the safest analgesic and antipyretic medicine for pregnant women, and it is widely used all over the world. However, prenatal acetaminophen was reported to be associated with asthma, lower performance intelligence quotient (IQ), shorter male infant anogenital distance (predicting poor male reproductive potential), autism spectrum disorder, neurodevelopmental problems (gross motor development, communication), attention-deficit/hyperactivity disorder, poorer attention and executive function, and behavioral problems in childhood. Each article has poor power to show risks of acetaminophen, however, the integration of the articles that showed adverse effects of acetaminophen may have power to show them. Acetaminophen use in childhood was associated with autism spectrum disorder, asthma symptoms, wheezing, and allergic disease. Acetaminophen is the safest medicine as analgesics for nociceptive pain and antipyretics in childhood and pregnancy. There is no alternative medication of acetaminophen. Acetaminophen should not be withheld from children or pregnant women for fears it might develop adverse effects. Acetaminophen should be used at the lowest effective dosage and for the shortest time. When we know the possible, rare but serious complications, we should use acetaminophen in pregnancy only when needed and no safer option for pain or fever relief is available. Health care providers should help inform the general lay public about this difficult dilemma.

Keywords: Acetaminophen; Paracetamol; Pregnancy; Risk; Safety


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About the article

Department of Rehabilitation, Kitahiroshima Town Toyohira Hospital, 4705 Azaka, Kitahiroshima Town, Yamagata-Gun, Hiroshima 731-1222, Japan

Received: 2017-07-06

Revised: 2017-09-05

Accepted: 2017-09-09

Published Online: 2017-12-29

Conflict of interest: No conflict of interest.

Citation Information: Scandinavian Journal of Pain, Volume 17, Issue 1, Pages 445–446, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2017.09.007.

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© 2017 Scandinavian Association for the Study of Pain. Copyright Clearance Center

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