Once again, Trump and Bobby Jr. are proven wrong
“Paracetamol (acetaminophen) remains a safe and essential
analgesic [pain reliever] and antipyretic [fever reducer] during pregnancy,
whereas alternatives, such as NSAIDs [non-steroidal anti-inflammatory drugs]
and opioids carry well-documented risks,” wrote the University of Hong Kong–led
research team.
“Unwarranted reluctance to use paracetamol could lead to
undertreatment of pain and fever, or the use of more harmful alternatives, both
posing risks to the pregnancy and developing fetus,” they added.
Safe when taken as clinically indicated
The researchers used electronic health records from the Hong
Kong Hospital Authority to identify pregnancies in which the mother received an
acetaminophen prescription and then created a group of mother-child pairs from
January 2001 through December 2023. The final group included mothers who had
another child, thus creating a sibling matched cohort.
The researchers examined 124,333 children (61,775 girls
[49.7%] and 62,558 boys [50.3%]) for autism. Being exposed to acetaminophen
during pregnancy did not increase the risk of having an ASD diagnosis.
They also looked at 97,285 children (48,455 girls [49.8%]) and 48,830 boys [50.2%]) for ADHD. Again, there was no increased risk of an ADHD diagnosis in children born to mothers who took acetaminophen during pregnancy.
While the study reinforces the safety of taking
acetaminophen during pregnancy, the researchers did not look at children whose
mothers took over-the-counter Tylenol rather than the prescription
medication.
“Clinicians should reassure patients that paracetamol
[Tylenol] is safe when used as clinically indicated, at the lowest effective
dose for the shortest necessary duration,” the authors wrote.
Tylenol ‘among the most used’ drugs in pregnancy
During a 2025 press
conference, Donald Trump said, without new evidence,
that pregnant women should stop using acetaminophen because of its alleged
relationship to autism.
“This was concerning given that acetaminophen is among the
most used medications in pregnancy for the management of pain and fever, in
part because alternative options are limited or contraindicated,” Brian K. Lee,
PhD, of Drexel University, and Viktor H. Ahlqvist, PhD, of Aarhus University in
Denmark, wrote in an accompanying commentary.
The president’s comments reduced pregnant women’s
willingness to take acetaminophen. Two recent papers, one published
in The Lancet and the other in Pediatrics,
found that fewer pregnant women took the medication after hearing the
unsupported claims.
Since then, an umbrella
review and a nationwide Danish study found
no association between maternal acetaminophen use and an increased risk of
autism.
“Taken together with prior evidence from Japan, Norway,
Sweden, and Taiwan, these findings from Hong Kong further reinforce the
conclusion that acetaminophen use during pregnancy is unlikely to increase the
risk of ASD or ADHD in exposed children,” Lee and Ahlqvist wrote.
They also noted that underfunding of research examining drug
safety during pregnancy has resulted in a dearth of data on various
medications’ impact on pregnant women and their children.
“Evidence on medication safety in pregnancy is typically
generated only after widespread clinical use, because pregnant individuals are
excluded from clinical trials,” they wrote. “This reactive and ad hoc paradigm
is suboptimal given that timely, high quality evidence is essential to inform
clinical decision making.”
