April 12, 2024 – Scientists and researchers have long raised concerns about the potential increased risks of autism and ADHD from taking acetaminophen during pregnancy, even though the FDA and the American College of Obstetricians and Gynecologists have said it's safe to use when you're carrying a child.
But new findings should bring comfort to pregnant people who need pain relief, given that full-dose aspirin and nonsteroidal anti-inflammatory drugs have been shown to pose serious risks to pregnant patients.
Taking over-the-counter pain relievers with acetaminophen, such as Tylenol, during your pregnancy will not increase your child’s risk of having autism, attention deficit hyperactivity disorder (ADHD), or an intellectual disability, a large study found.
If a pregnancy results in an abnormal outcome, patients are often quick to blame themselves, picking out every moment they might have messed up during their pregnancy, explained Jeffrey Kuller, MD, a maternal-fetal medicine specialist from Duke University.
“Recall bias is a real thing,” said Kuller, who was not involved with the study. “There’s this guilt. ‘Did I cause this? Was it because of the cigarette I smoked or the drink I had before I knew I was pregnant?'”
In reality, when a child has autism, ADHD, or a learning disability, the causes are usually many, and we don’t yet fully understand why some children have these problems with brain development.
“I think it’s quite unlikely that it was the Tylenol somebody took during pregnancy that led to those outcomes,” Kuller said. “That’s a huge reach and just a way to make people who are already feeling badly about a difficult situation feel so much worse.”
The study, led by researchers from Drexel University and the Karolinska Institute in Sweden and published this week in The Journal of the American Medical Association, analyzed medical record data from almost 2.5 million children born in Sweden from 1995 to 2019.
The findings showed a slightly increased risk of autism, ADHD, and learning disabilities when comparing children exposed to acetaminophen during pregnancy to those who weren’t. But when the data was extended to include full sibling pairs (those from the same biological parents), no evidence was found to link Tylenol with a higher risk of autism, ADHD, or learning disabilities.
Using a sibling analysis in a large study like this irons out any genetic and environmental factors that weren't seen before. The authors said the slight link between Tylenol use during pregnancy and autism, ADHD, and learning disabilities when sibling controls are not taken into account is likely passed down through genes that lead to problems with development and because “those who used acetaminophen during pregnancy reported higher prevalence of multiple health conditions associated with neurodevelopmental disorders compared with nonusers,” they wrote.
