Tylenol during pregnancy not linked to autism, ADHD, major review finds

Bobby Junior, wrong again

Meghan Holohan

In the midst of increasing misinformation about acetaminophen (Tylenol) and its relationship to autism, many expecting women feel confused about what they should take if they experience a fever. A paper published today found that there’s no causal link between acetaminophen use during pregnancy and autism or attention deficit, hyperactivity disorder (ADHD).  

“A widely debated question deserves more than headlines—it deserves robust evidence,” first author Hoda Tayebi Hillali, DDS, MSc, of the University of Santiago de Compostela, in Spain, said in a press release from Wiley, publisher of the journal that posted the study. “Our findings show that the apparent association between prenatal paracetamol [acetaminophen] exposure and autism or ADHD weakens as methodological quality improves, challenging the interpretation of a causal link and supporting evidence-based decisions during pregnancy.” 

Acetaminophen ‘appropriate first-line treatment’

The umbrella review, published in Developmental Medicine & Child Neurology, included data from seven meta-analyses that involved more than 3 million participants. While unrestricted evaluation showed a slight association between moms using acetaminophen and a child’s autism or ADHD risk—a risk ratio of 1.17 and 1.29, respectively—when examining high-quality data the relationship no longer existed. 

“The observed associations between prenatal paracetamol exposure and neurodevelopmental disorders are probably influenced by methodological limitations,” the authors wrote. “Current epidemiological evidence does not support a robust causal relationship, and paracetamol remains an appropriate first-line treatment during pregnancy when clinically indicated.”

The findings of this review reinforce what past research suggests about maternal acetaminophen use and autism or ADHD diagnoses in children. 

A study from June in JAMA Internal Medicine found no association between moms who use the medication—one of the few pain and fever relievers that can be used in pregnancy—and their child being diagnosed as having neurodevelopmental conditions. Additionally, another umbrella review and a Danish national study also uncovered no relationship between mothers’ use acetaminophen and their children’s diagnoses with autism or ADHD. 

“At present, the available epidemiological evidence does not support changes to existing prescribing recommendations when considering the balance of risks and benefits, taking into account the potential consequences of untreated maternal fever, pain, or inflammatory conditions during pregnancy,” the authors wrote.