The federal government’s reported plans to link pregnant people’s use of acetaminophen — the pain-relief drug sold under the brand name Tylenol — as a cause of autism could worsen their health and stigmatize one of the few treatments pregnant people have for reducing pain and fever, doctors warn.
“Not only is it false to say Tylenol causes autism, it’s really dangerous,” said Dr. Bhaskari Burra, an OBGYN in Asheville, North Carolina. “If people are hesitant to take Tylenol in pregnancy, it’s really concerning.”
The claim, reported in the Wall Street Journal, is expected to be included in a Health and Human Services report that has not yet been released publicly. It is the latest in a series of efforts by the department, headed by the anti-vaccine conspiracy theorist Robert F. Kennedy Jr., to discourage pregnant people from taking medications that scientific evidence and medical experts say improves health.
Researchers have been studying acetaminophen — the most common over-the-counter pain and fever medication for pregnant people — and its potential impact on fetal development for years. Though some work in the past has suggested a possible link between acetaminophen and neurodevelopmental disorders, more scholarship has refuted those connections. Last year, a study in the medical journal JAMA found there was no link between taking acetaminophen in pregnancy and childhood autism or intellectual disability.
“The link between Tylenol in pregnancy and autism has not been shown. It is not borne out in the data,” Burra saud. “We don’t have any data to show that Tylenol causes autism.”
The American College of Obstetricians and Gynecologists has long recommended that pregnant people can use acetaminophen safely in consultation with their doctor. The organization swiftly criticized any possible report that might link taking acetaminophen in pregnancy with autism.
Since drugs are not often tested on pregnant people, acetaminophen is one of the few drugs pregnant people can safely use to relieve pain or fever — conditions that, if left untreated, can increase the risk of birth defects and premature delivery. Ibuprofen, another common pain reliever, has been associated with fetal heart problems and low amniotic fluid, which can also put pregnancies at risk.
“There’s benefits to controlling fever. There’s benefits to controlling pain,” said Dr. Zoe Taylor, a Washington-based family medicine physician who practices primary care, including a focus on addiction and pregnancy. “Not to mention all the other medications that I’m worried RFK Jr. is going to vilify as well, that have really significant benefits to patients and future children.”
Dr. Mariana Montes, a Chicago-based obstetric anesthesiologist, said she worries that if pregnant people believe they cannot use acetaminophen, they will turn to riskier options for pain management: ibuprofen, which can harm a pregnancy, or opiates. Untreated pain also can put a pregnancy at risk.
“What they really want is they think if the mother suffers, the pregnancy will be the most healthy, and that is not true,” Montes said.
Earlier this summer, an advisory panel to the Food and Drug Administration suggested pregnant people should avoid a class of antidepressants called selective serotonin reuptake inhibitors — drugs including Prozac, Lexapro and Zoloft — claiming that taking them while pregnant could cause pregnancy loss, birth defects or autism. There is also no evidence linking antidepressant use to such health outcomes.
Taylor said she meets with pregnant patients who are already very concerned about the health of their fetuses over their own wellbeing. She said medical professionals use the best science to advise patients about the risks and benefits of any medications they may be on at the start of their pregnancy or during, including SSRIs.
“We do a lot to try to help patients understand that in many circumstances, staying on those medications is better for them and their baby. So I hate the idea that some of that work could be undone by misinformation,” she said. “There’s already plenty of misinformation about that on TikTok that we are dealing with, combating in visits every day — if it comes from the federal government, that’s even harder to explain.”
In fact, both medications can actually keep pregnancies healthy. Patients who abruptly halt an antidepressant regimen can be at risk of serious self-harm; their babies too can be at greater risk of preterm birth, and of developing depression later in life.
Taylor said while it is important for the federal government and researchers to investigate the causes of autism, she is skeptical about the evidence that will be cited in this upcoming report. A recent systematic review of acetaminophen and autism only summarized prior studies and was not quantitative.
“I’m worried about what this says about the process that is happening. It’s not science and it is not expert review and guidelines anymore. It’s like, vibes,” she said. “That’s the thing that makes me worried — one article can come out that happens to get on one person’s desk and it makes a huge deal out of something. That’s not the way the process is supposed to work.”
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