Acetaminophen in Pregnancy: A Population-Level Drug-Utilization Study of Prescription-Based Acetaminophen Use Among Pregnant Women in Denmark From 2001 to 2023

Abstract

Acetaminophen is the most used analgetic drug for pain management during pregnancy. A recent academic controversy concerns the safety of acetaminophen during pregnancy related to a potentially increased risk of adverse neurodevelopmental effects. We investigated the population-level trends in prescription-based use of acetaminophen among pregnant women in Denmark between 2001 and 2023. Prescription-based sals of acetaminophen among pregnant women and comparison groups were retrieved from 'eSundhed', a publicly available dataset curated by the Danish Health Authorities. The number of prescription-based drug users per 1000 pregnant women increased slightly from 2001 to 2012 (3.9 to 6.5 per 1000) and 2015 to 2023 (52 to 76 per 1000), interrupted by a drastic increase in 2013/2014. Acetaminophen use among pregnant women (2023: 76 per 1000) was lower than in women in an age-matched comparison group (137 per 1000) and in women 12-3 months prior to pregnancy (124 per 1000). Time trends did not notably differ between age groups or comparison groups. Prescription-based acetaminophen sales among pregnant women increased by 50% from 2015 to 2023. A general shift in the prescription pattern towards a substantial increase in prescription-based exposure was observed following legislation changes in 2013, restricting sales of large packages to prescription.

Keywords: acetaminophen; drug‐utilization; population‐based; pregnancy; prescription.

FIGURE 1

Trends in number of prescription‐based drug users of acetaminophen (ATC: N02BE01) per 1000 individuals of different groups in the years 2001–2023.

FIGURE 2

Trends in volume sold (1000 DDD) and proportion of prescription sales of total primary sales of acetaminophen (ATC: N02BE01) in the years 2001–2023. DDD: daily defined doses.