Acetaminophen use during pregnancy does not increase the risk of autism and attention-deficit hyperactivity disorder: a review

A large new review published Friday found that using acetaminophen as directed during pregnancy does not increase a child’s risk of autism, attention-deficit hyperactivity disorder (ADHD) or intellectual disability.

Acetaminophen, also known as paracetamol and by the trade name Tylenol, is one of the most commonly used medications during pregnancy, with doctors often recommending it as a first choice for pain or fever, but in limited use.

Previous studies have yielded mixed results, with some suggesting… The medication may be associated with an increased risk of autism Or ADHD in children, leaving some pregnant women unsure how safe it is.

In a new meta-analysis, published in The Lancet Obstetrics, Gynecology & Women’s Health Researchers reviewed the results of about 60 studies.

They found no link to developmental disorders in children when pregnant people used acetaminophen according to the label, in one of the most comprehensive evaluations of the evidence to date.

“The clearest conclusion to conclude is that the best-quality evidence does not support a causal relationship between taking paracetamol during pregnancy and autism or ADHD in children,” Dr. Asma Khalil, study co-author and professor of obstetrics and maternal-fetal medicine at St. George’s Hospital in London, told ABC News.

She added: “Pregnant women should feel reassured that paracetamol remains the recommended first-line option for pain or fever during pregnancy when used as directed.”

In September, President Donald Trump to caution Use of acetaminophen during pregnancy “is associated with an increased risk of autism,” and the president advised pregnant women, “Don’t take Tylenol.”

The president has since repeated this claim on social media, suggesting that young children, including infants, should not be given the drug, without providing evidence to support this statement.

The FDA also issued a memo at the time to doctors about a possible link between acetaminophen during pregnancy and autism. The memo included language that there is no evidence that Tylenol causes autism, and that the link is an ongoing area of ​​scientific debate.

In a statement to ABC News, the Department of Health and Human Services said, “Many experts They expressed their concern Of use Acetaminophen During pregnancy.”

Major medical groups reacted strongly, expressing concern that pregnant women might be discouraged from using acetaminophen even if they could benefit from it.

Kenvue, the maker of Tylenol, said at the time that it believed research showed that acetaminophen did not cause autism.

In a new statement to ABC News, Kenvue said it will review the new analysis upon publication.

“Our view of current science remains the same: we believe independent, sound science shows that Tylenol is safe and that taking acetaminophen does not cause autism,” the statement read.

The new review focused on sibling comparison studies, which look at siblings born to the same mother when one pregnancy was taking acetaminophen and the other was not. Because siblings share genes and family environment, this design helps separate drug effects from family background.

In sibling comparison analyses, acetaminophen exposure during pregnancy was not associated with autism spectrum disorder, ADHD, or other intellectual disability. This finding held up even in studies that were followed for more than five years, the researchers said.

The review may help explain why previous observational studies have shown a possible link between acetaminophen use in pregnancy and developmental disorders, the authors said.

People do not take acetaminophen randomly but for symptoms such as fever, infection, inflammation or pain, the researchers said. These symptoms may also be related to fetal brain development, making it possible to confuse the effects of the underlying condition with those of the drug.

Jessica B said: Steyer, who leads the science communication group Unbiased Science and was not involved in the review, told ABC News that not treating symptoms, such as fever, can be harmful to both the pregnant woman and the fetus.

“Untreated fever has been documented to be associated with serious risks to pregnancy and the fetus,” she explained. “Alternative pain relievers — NSAIDs and opioids — carry their own pregnancy risks. Acetaminophen remains the safest option when medication is needed.”

Studies linking acetaminophen use during pregnancy to autism or other conditions are vulnerable to misunderstanding and can be compelling, especially when shared on social media, Steyer added.

A Department of Health and Human Services official told ABC News that the new analysis “does not solve an important public health problem; it avoids it.” The vast majority of relevant evidence, and in favor of a single study design known to bias results toward the null and skew statistical power, the authors modeled outcomes rather than assessed causality.

Khalil said patients should use the lowest effective dose for the shortest period of time and seek medical advice if symptoms persist, are severe or recurrent – especially fever.

The authors said there were limitations to the review, including a lack of studies using sibling-based designs, which prevented the team from accounting for other variables that could influence painkiller use or lead to neurodevelopmental disorders.

However, they add that the new review’s findings are consistent with guidelines from several professional medical organizations, including the American College of Obstetricians and Gynecologists (ACOG).

Collaborative team It is recommended Use acetaminophen when needed, follow label instructions, seek medical guidance when appropriate, and pay attention to symptoms that prompt use of the medication.

Recurrent or high fever, severe pain or symptoms that do not improve during pregnancy could indicate an underlying problem that needs medical attention, according to ACOG.

“It is always sensible to use paracetamol appropriately during pregnancy: the lowest effective dose for the shortest period of time, and avoid unnecessary prolonged use without medical review,” Khalil said.

Radhika Malhotra, MD, is an internal medicine and preventive medicine resident at Rutgers New Jersey Medical School and a member of the ABC News Medical Unit.

Yuri from ABC News Ben Joud contributed to this report.