The Gaping Lack of Drug Studies in Pregnancy
The recent brouhaha over whether acetaminophen (the active ingredient in Tylenol) causes autism misses a key point about our knowledge of drugs that are safe to take while pregnant. While the evidence on acetaminophen does not show a convincing link to autism, we know far less about other medications in pregnant people because they simply aren’t included in most clinical trials or post-approval studies.
As many as 90 percent of people take at least one medication while pregnant, yet fewer than 1 percent of clinical trials include pregnant people. I talked to Alyssa Bilinski, an assistant professor of health policy at the Brown University School of Public Health, who has studied this gap. “There’s a growing consensus that we should be thinking less about protecting pregnant women from research and instead think about the benefits of protecting people through research,” Bilinski says.
Bilinski and others say this has to change. If we had done clinical trials of thalidomide, we might’ve prevented tens of thousands of birth defects in children, because the dangers would have become clear in a much smaller population. And many drugs are essential during pregnancy, including drugs for hypertension, HIV and mental health. There are ways to study the effects of drugs in these individuals ethically, and it’s essential to gain the knowledge needed to inform people who are pregnant, experts say. Read more in my story, above.
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—Tanya
