Researchers have found no evidence that taking acetaminophen, also known as Tylenol or paracetamol, during pregnancy causes autism spectrum disorder in children. Medical experts point to the necessity of safe pain and fever management during pregnancy, as alternatives such as ibuprofen and opioids carry known risks.
Despite concerns raised by the Trump Administration on September 22 about a possible link between acetaminophen use during pregnancy and autism, leading medical organizations disagree with recommendations to avoid the drug. Dr. Jennifer Braverman, a maternal fetal medicine specialist at UCHealth Maternal Fetal Medicine Clinic – Anschutz Medical Campus and associate professor at the University of Colorado School of Medicine, stated: “The best-available data do not support this recommendation.”
Major medical bodies including the American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine, and medication-safety authorities in the European Union, United Kingdom, and Australia share this view. Recent peer-reviewed studies support their stance; a Swedish study involving 2.5 million children published in the Journal of the American Medical Association in August and a Japanese study of 217,000 children both found no relationship between maternal acetaminophen use and autism.
While some research has reported an association between prenatal acetaminophen exposure and autism, no causative link has been established. A Harvard-led review that analyzed eight studies did find a higher risk among exposed children but did not demonstrate causation.
Autism’s causes remain unclear but involve both genetic and environmental factors. Boys are diagnosed more often than girls, siblings of affected children have increased risk suggesting genetics play a role, and older parental age is also linked to higher incidence rates. Environmental contributors include air pollution, low birth weight, gestational diabetes, maternal obesity, and infections during pregnancy.
Braverman cautioned against misinterpreting associations found in early studies: “It is possible that fever, inflammation, or infection, rather than acetaminophen use itself, led to the association seen in these small studies between acetaminophen exposure and autism,” she said.
Experts warn that untreated fevers can be dangerous for pregnant women and their babies. According to Braverman: “Fever has been associated with a lot of problems for babies… people are either going to not treat fever, which we know is dangerous for fetuses, or that people are going to turn toward medications that we know are unsafe in pregnancy.” She added regarding acetaminophen: “I think it’s the safest option we have.”
Dr. James Burton from UCHealth Hepatology Clinic – Anschutz Medical Campus explained that acetaminophen is generally safe even for patients with chronic liver disease when taken within recommended doses. “Tylenol is safe to take, even if you have cirrhosis… It’s actually safer than taking ibuprofen in people with chronic liver disease,” Burton said.
Both physicians agree that medication should only be used when necessary. Braverman advised: “I tell my patients… you shouldn’t take a medicine for no reason… If you have a fever [or] pain… Tylenol is a safe and effective treatment for those things.”
