Fever & Pregnancy: Experts Urge Caution with Pain Relievers, Prioritize Acetaminophen
SEOUL, SOUTH KOREA – Recent discussions surrounding safe fever reduction during pregnancy have prompted renewed guidance from medical professionals and the Ministry of Food and Drug Safety (MFDS). While minimizing medication is generally advised, persistent high fever poses risks too fetal advancement, making informed choices crucial.
Acetaminophen (commonly known as Tylenol) is currently considered the safest option for fever and pain relief during pregnancy when used at appropriate doses and under expert guidance. Though, alternatives like ibuprofen and aspirin carry significant risks.
Ibuprofen, stimulating the gastric mucosa, can cause heartburn or gastritis and perhaps strain the kidneys. Critically, it can directly impact the fetus from the 20th week of gestation. Reported risks include “undercollapse of amniotic fluid” – a decrease in fetal kidney function or amniotic fluid volume – and “early closure of the arterial duct,” a premature closing of fetal blood vessels. The MFDS recommends avoiding ibuprofen after 30 weeks of pregnancy and utilizing the lowest effective dose for the shortest duration between 20 and 30 weeks. Adult dosage guidelines for ibuprofen are 200-400mg every 6-8 hours, with a daily maximum of 1200mg for over-the-counter use. Prescription dosages can reach 3,200mg daily under medical supervision, though studies indicate doses of 2,400mg per day may slightly elevate the risk of myocardial infarction or stroke.
Aspirin, containing acetyl salicylic acid, is primarily used for cardiovascular disease prevention through blood thinning in adults and is rarely recommended for fever reduction. The most prominent brand in Korea is Bayer’s “Aspirin.” A significant concern is Reye’s syndrome, a potentially fatal condition causing brain and liver damage, triggered by aspirin use following viral infections like the flu or chickenpox. Consequently,aspirin is not recommended for individuals under 15. It also poses risks to pregnant women, potentially increasing bleeding and impacting fetal vascular development, though low doses might potentially be prescribed by specialists for specific conditions like prenatal blood clot prevention.
experts emphasize that the question isn’t simply whether acetaminophen is safe, but rather that pregnant women should minimize medication while acknowledging the detrimental effects of prolonged high fever on fetal nervous system development. Appropriate acetaminophen dosage, guided by a healthcare professional, is therefore the recommended course of action.
