Can women ignore some cases of fever in early pregnancy or should all be manged with medications? That is sometimes a dilemma for pregnant women who endeavour to stay away from all medications during the first three months to reduce the risk of birth defects. Although, avoiding medications other than vitamins and folic acid during pregnancy is still recommended, a new study suggests that using medications to reduce fever should be an exception because fever irrespective of the cause may lead to serious congenital problems in the unborn child.
This is the finding of a new study published October 10, 2017 in the peer reviewed journal, Science Signaling. It was based on a study conducted in animal embryos.
According to the researchers, some birth defects could be prevented by lowering the mother’s fever with the use of acetaminophen during the first three months of pregnancy.
How was the research conducted?
To observe how fever impacts a developing fetus, the researchers studied zebrafish and chicken embryos. Among their discoveries, the scientists found that neural crest cells — cells that are critical building blocks for the heart, face and jaw — contain temperature-sensitive properties. “We found that these neural crest cells contain temperature-sensitive ion channels that typically are found in your sensory neurons,” Benner said. “They’re the channels that, when you stick your hand in a hot cup of water, tell your body the temperature has changed.”
The Duke researchers engineered a noninvasive magnet-based technology to create fever-like conditions in two specific temperature-sensitive ion channels called TRPV1 and TRPV4 in the neural crest cells involved in developing the heart and face. When those neural crest cells were subjected to conditions mimicking a transient fever, the embryos developed craniofacial irregularities and heart defects, including double outlet right ventricle, Tetralogy of Fallot and other outflow obstructions.
Dr Eric Benner, a neonatologist and assistant professor of pediatrics at Duke said:
“My hope is that right now, as women are planning to become pregnant and their doctors advise them to start taking prenatal vitamins and folic acid, their doctor also informs them if they get a fever, they should not hesitate to call and consider taking a fever reducer, specifically acetaminophen (paracetamol), which has been studied extensively and determined to be safe during the first trimester.
While doctors advise most women to avoid any drug during pregnancy, there may be benefits to taking acetaminophen to reduce fever. Women should discuss all risks and benefits with their doctors.”
‘’ The judicious use of (acetaminophen) for an acute problem such as fever is considered safe. These findings suggest we can reduce the risk of birth defects that otherwise could lead to serious health complications requiring surgery.
“I hope moving forward, we can educate more women about fever as a risk factor for birth defects and let them know they shouldn’t just tough it out if they develop a fever. They should ask their doctor before getting pregnant whether they may benefit from taking a fever-reducer such as acetaminophen in the event they develop a fever.”
Why is this information important?
In many developing countries, infectious diseases (resulting in fever) are quite common. For example, one study in Nigeria, one out of four women reported malaria associated fever. This suggests that fever occurs commonly in pregnancy. Some women are forced to choose between ‘enduring’ bouts of fever during the first trimester and taking medications (such as antimalarial or antibiotics) that may increase the risk of birth defects.
Some studies have suggested that the use of acetaminophen may also result in rare but serious complications. For instance, it was found to be associated with asthma, autism spectrum disorder and behavioral problems in childhood. However, it is still the safest reliever of pain and fever in pregnancy.