More Heads-Ups for Pregnant Women

"We would encourage women to think carefully before taking painkillers in pregnancy and to follow existing guidelines -- taking the lowest possible dose for the shortest time possible."
Dr. Rod Mitchell, researcher, The Centre for Reproductive Health, University of Edinburgh

"Paracetamol and ibuprofen are commonly used during pregnancy.  However, over the last year, a growing number of reports have suggested that we might need to take a closer look at their safety in unborn babies. This latest study raises the possibility that paracetamol and ibuprofen may reduce the growth of the ‘germ cells’ which later become eggs or sperm in unborn babies."
"While it is still premature to stop taking these important drugs, there is a growing case to investigate their safety for pregnant women."
Dr Channa Jayasena, senior clinical lecturer, reproductive endocrinology, Imperial College London

Women are advised to avoid painkillers during pregnancy Credit: Getty

A new study out of the University of Edinburgh, led by Dr. Rod Mitchell and published in Environmental Health Perspectives, points out that the use of common painkillers such as acetaminophen during pregnancy could be problematical, impacting not only in the next generation but the one succeeding it. The study concluded that women would benefit hugely from refraining from the use of ibuprofen or acetaminophen during pregnancy.

There have been previous studies which also found that ibuprofen could harm girls' fertility and women have been advised to avoid the medication throughout pregnancy, that they might, should they require relief from pain, take acetaminophen instead (also known as paracetamol), but for as brief a time as possible. This latest study, however, has found that neither of these two drugs should be advised for use during pregnancy as both impact on the fertility in the uterus of subsequent offspring.

It is estimated that one in three women use painkilling drugs like these during pregnancy. Their impact was seen in both male and female tissues. The medication was found during the study, to make marks on the DNA whose consequences were of a permanent nature. A one-week exposure to acetaminophen by ovaries resulted in over 40 percent fewer egg-producing cells. Ibuprofen exposure had an even more devastating impact in reducing egg-producing cells from exposed ovaries.

As for testicular tissue exposed to painkillers in a laboratory culture dish, the result was 25 percent fewer sperm-producing cells resulting from exposure to either acetaminophen or ibuprofen. Samples of human fetal testes and ovaries were used by the University of Edinburgh scientists in combination with acetaminophen and ibuprofen, with similar effects discovered with the use of various experimental protocols.

The results were clear, however; human tissues exposed to one drug or the other for a one-week period in a petri dish significantly reduced cell numbers giving rise to sperm and eggs, called germ cells. In girls who produce all their lifetime eggs while in the womb, the effect could lead to an early menopause if they are born with a reduced number of germ cells.

The number of sperm-producing cells dropped by 17 percent with one day of treatment with acetaminophen.

Exposure to acetaminophen or ibuprofen triggers mechanisms in the cell, leading to changes in the DNA structure; epigenetic marks. The effects of painkillers on fertility may be passed on to future generations since epigenetic marks can be inherited.

Taking painkillers during pregnancy could affect the fertility of the unborn child in later life, new research suggests.  BBC

"This is an interesting study which suggests taking paracetamol and ibuprofen during pregnancy might affect the fertility of the unborn child by reducing the number of cells that give rise to sperm and eggs."
"It is important to note that this study was carried out on human fetal testes and ovaries and animal models, so definitive conclusions cannot be drawn.  It is also not possible to translate the findings into a recommendation on what would be a safe or unsafe amount of paracetamol or ibuprofen to take while pregnant."
"More research is needed into the long term effects of paracetamol and ibuprofen use in pregnancy on the fertility of the unborn child."
"Women should not be alarmed by the results of this study.  Paracetamol is widely accepted as a safe painkiller for pregnant women to take, and can be very beneficial when a pregnant woman is suffering with a migraine, for example.  We recommend that women follow current guidance and take the lowest effective dose of paracetamol for the shortest possible time.  If this doesn’t treat the pain, they should to speak to their GP, midwife, or obstetrician. Pregnant women are generally advised to avoid taking ibuprofen as it is associated with an increased risk of complications."
Dr Patrick O’Brien, Consultant Obstetrician, spokesperson , Royal College of Obstetricians and Gynaecologists, Britain: Science Media Centre

Painkillers could harm future fertility of subsequent offspring   Credit: Dominic Lipinski/PA