April 11, 2024 – Scientists and researchers have long raised concerns over the potential increased risks of autism and ADHD from taking acetaminophen during pregnancy, despite it being deemed safe for gestational use by the FDA and the American College of Obstetricians and Gynecologists.
But new findings should bring comfort to pregnant people who need pain relief, given that full-dose aspirin and non-steroidal 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 developing 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 an intellectual disability, the causes are usually many, and we don’t yet fully understand why some percent of children have these neurodevelopmental abnormalities.
“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 JAMA, analyzed medical record data from almost 2.5 million children born in Sweden between 1995 to 2019.
The findings showed a slightly increased risk of autism, ADHD, and intellectual disability when comparing children exposed to acetaminophen during pregnancy to those who weren’t. However, 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 intellectual disability.
Using a sibling analysis in a large population study like this irons out any previously unobserved genetic and environmental factors. The authors said the slight link between Tylenol use during pregnancy with autism, ADHD, and intellectual disability when sibling controls are not taken into consideration is likely passed down through genetics of neurodevelopmental disorders, and because “those who used acetaminophen during pregnancy reported higher prevalence of multiple health conditions associated with neurodevelopmental disorders compared with nonusers,” they wrote.
