New Research Challenges Trump’s Acetaminophen Autism Claims

When former President Donald Trump suggested in September 2022 that taking acetaminophen, commonly known as Tylenol, during pregnancy might be linked to an increased risk of autism, the medical community swiftly responded. Many healthcare professionals, including obstetrician Dr. Nathaniel DeNicola, experienced a surge in questions from concerned patients. Despite the initial spike in anxiety, DeNicola noted that the topic soon subsided. “After a week, it had kind of gone away as a hot-button topic,” he said, highlighting the medical community’s prompt clarification on the safety of acetaminophen during pregnancy.

Dr. DeNicola, who contributed to the guidelines from the American College of Obstetricians and Gynecologists (ACOG) regarding acetaminophen use, emphasized that the overwhelming response from experts helped mitigate lasting confusion. “Patients, I think correctly, are going to their doctors,” he stated, indicating that the public largely trusts medical professionals for guidance on health matters.

Dr. Lynn Yee, a maternal-fetal medicine physician based in Chicago, observed a decline in patient concerns regarding acetaminophen in early 2023 compared to the previous autumn. “In September, October, November, there was quite a bit of public concern and attention on this topic, and now… I feel like things are changing,” she remarked. Yee credited professional organizations for their effective communication about acetaminophen’s safety, underscoring their role in reassuring the public.

The scientific consensus reveals that autism has multiple potential causes, including genetics and environmental factors such as prenatal exposure to air pollution. ACOG reiterated in its guidance that “acetaminophen remains the analgesic and antipyretic of choice during pregnancy.” The organization advises judicious use at the lowest effective dose, confirming that acetaminophen is the safest over-the-counter option for treating pain or fever during pregnancy.

Leaving a fever untreated can pose serious risks to both the mother and the fetus, potentially leading to complications such as miscarriage or birth defects. Dr. Yee warned, “Untreated fevers can have short- and long-term impacts on fetal neurodevelopment.” Given these concerns, healthcare providers often recommend acetaminophen to manage fevers effectively.

In September 2022, the White House released a fact sheet stating that studies indicated a possible association between acetaminophen use in pregnancy and long-term neurological issues in children, including autism. The U.S. Food and Drug Administration (FDA) subsequently advised clinicians to consider minimizing acetaminophen use during pregnancy for low-grade fevers. One of the studies referenced was a review of 46 earlier studies, which alleged a connection between prenatal acetaminophen use and neurodevelopmental disorders.

Dr. Andrea Baccarelli, a senior author of the review published in BMC Environmental Health, noted that the association between acetaminophen use and increased risk of autism is strongest when taken for four weeks or longer. He emphasized the importance of balancing potential risks with the need for pain management during pregnancy.

Recent research published in The Lancet Obstetrics, Gynaecology & Women’s Health provides new insights into this ongoing discourse. A study analyzing data from over 300,000 pregnancies found no evidence that acetaminophen use during pregnancy increases the likelihood of autism or related neurodevelopmental disorders. Dr. Asma Khalil, the lead author, stated, “This review provides reassurance rather than alarm… and it supports current clinical guidance that paracetamol remains an appropriate first-line treatment for pain and fever in pregnancy when used as recommended.”

While the U.S. Department of Health and Human Services acknowledged that the new findings do not resolve all questions regarding acetaminophen’s safety, Dr. Khalil defended her study’s methodology. She argued that it systematically evaluated studies to minimize bias and provided a clearer picture of the potential risks.

Dr. Steven Kapp, a senior lecturer in psychology at the University of Portsmouth, praised the new research for including sibling-comparison analyses, which help account for familial and genetic factors that may influence autism risk. He emphasized the importance of focusing on making societal improvements for individuals with disabilities rather than seeking out unfounded prevention methods.

Dr. DeNicola acknowledged the value of the new research but noted the limited number of sibling studies conducted to date. “But considering that all three studies say the exact same thing, done with superior methods, it at least provides the reassurance to date that we should be using the therapeutic benefit of Tylenol without any unfounded risk,” he said.

The dialogue surrounding acetaminophen use during pregnancy is likely to evolve as additional research emerges. For now, healthcare professionals continue to advocate for informed discussions between patients and their doctors, emphasizing the importance of using acetaminophen responsibly to manage pain and fever during pregnancy.