Tylenol use and autism: A large new review of medical research has found no evidence that taking Tylenol during pregnancy increases the risk of autism, ADHD, or intellectual disability in children, reinforcing conclusions reached by many earlier studies and challenging claims promoted by the Trump administration.
The review, published in a leading medical journal focused on obstetrics and women’s health, examined 43 studies that looked at acetaminophen use during pregnancy and neurodevelopmental outcomes in children. Researchers concluded that the most methodologically rigorous studies, particularly those comparing siblings, consistently showed no causal link between the drug and autism, ADHD, or intellectual disabilities.
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The authors said acetaminophen remains safe to use during pregnancy and continues to be recommended as a first-line treatment for pain and fever when clinically needed.
The findings come amid renewed political attention on the issue. Last year, President Donald Trump publicly warned pregnant women against taking Tylenol, citing unproven claims that the medication could be linked to autism.
While some observational studies over the years have suggested a possible association between prenatal acetaminophen use and neurodevelopmental conditions, most large and carefully designed studies have not supported that conclusion. A major review published last year reported that existing evidence does not clearly link the drug to autism or ADHD, and a previous sibling-comparison study likewise found no increased risk for autism, ADHD, or intellectual disability.
Despite this broader body of evidence, the White House has highlighted research that suggests a connection. One such paper, published last year, reviewed dozens of studies and reported an association between acetaminophen exposure during pregnancy and higher rates of neurodevelopmental disorders. The authors of that paper emphasised that acetaminophen remains important for treating pain and fever during pregnancy but suggested limiting its use as a precaution.
Several health experts have criticised how that review has been interpreted publicly, noting that only a small subset of the included studies focused specifically on autism and that an association does not establish cause and effect. Critics have also pointed out that some of the studies included were small or vulnerable to bias.
Researchers involved in the latest review said studies suggesting a link are particularly susceptible to confounding factors. For example, acetaminophen is often used to treat fever, and fever during pregnancy itself may increase the risk of neurodevelopmental conditions. Recall bias may also affect results when mothers are asked to remember medication use years after pregnancy.
When these factors are accounted for, especially through sibling-comparison studies that help control for genetics and shared family environment, the apparent association disappears, the authors said.
Experts note that genetics remains the strongest known risk factor for autism. Other factors linked to increased risk include advanced paternal age, preterm birth, and certain maternal health conditions during pregnancy.
The authors stressed that public health guidance should be based on the totality of high-quality evidence and cautioned against messaging that could deter pregnant women from using a medication that is widely considered safe and effective when used appropriately.