A forthcoming federal report, set for release on Monday, is anticipated to draw a connection between increasing autism rates and acetaminophen, the key ingredient in popular painkillers like Tylenol. While scientists have explored this potential link for many years, their findings to date remain largely inconclusive.
Regarding acetaminophen, President Trump commented to reporters on Sunday, stating, “I think it’s a very big factor.”
According to a Sunday report by The Washington Post, the agency intends to advise pregnant women to avoid acetaminophen unless for fever. Speaking from Air Force One, Mr. Trump remarked, “If there’s a question — even if there’s a question — you just do it right?”
Acetaminophen is generally regarded as one of the safer choices for managing pain or fever during pregnancy. Healthcare providers commonly caution pregnant women against its prolonged use.
Additionally, the report expected this afternoon is set to suggest leucovorin, a type of B vitamin (folate), as a potential autism treatment. Folate has been recognized for its role in neural development for a considerable time.
For years, concerns have circulated regarding acetaminophen’s potential link to developmental issues in children. However, the scientific consensus strongly asserts that autism arises from an intricate interplay of genetic and environmental elements, making it unlikely that a single factor could explain increasing rates.
This new federal report follows a month after a significant data review by epidemiologists from the Harvard T.H. Chan School of Public Health and the Icahn School of Medicine at Mount Sinai. That review indicated a possible connection between acetaminophen use during pregnancy and neurodevelopmental conditions such as ADHD and autism.
Research exploring the potential risks to fetal brain development has produced conflicting outcomes. Some studies have identified a link to neurodevelopmental disorders in children, while others have found no such association.
Major health organizations, including the Food and Drug Administration, the European Medicines Agency, and the Society for Maternal-Fetal Medicine, have all assessed the existing evidence and concluded that the findings regarding this link are inconclusive.
Despite the mixed results, some scientists advocate for a precautionary approach, suggesting that healthcare providers should inform pregnant women about the potential, albeit unproven, link between acetaminophen and autism.
Conversely, experts in maternal-fetal medicine contend that such a strong recommendation is unwarranted. They point to existing guidelines that already advise pregnant women to use Tylenol and other acetaminophen-containing medications sparingly, and express concern that overly strong warnings might lead women to avoid necessary treatment.
Dr. Nathaniel DeNicola, an advisor to the American College of Obstetricians and Gynecologists on environmental matters, stated, “There’s no credible scientific link that Tylenol causes autism.”
He further elaborated that the studies investigating this connection are “too deeply and fundamentally flawed to draw reliable conclusions.”
Even the authors of the most recent report emphasized that their findings do not establish a cause-and-effect relationship.
Due to ethical constraints preventing pharmaceutical trials on pregnant women, all current research into acetaminophen’s effects is observational. This involves researchers analyzing existing data from pregnancies and then tracking the children’s development over time.
Consequently, it’s challenging for researchers to account for all potential differences between pregnant women who use Tylenol and those who do not, which could influence outcomes.
Dr. Brian Lee, a professor of epidemiology at Drexel University, noted that many studies within the recent review “did not necessarily go to the greatest lengths to account for possible confounders” — other factors that could explain a perceived link.
He further emphasized that “the biggest elephant in the room here is genetic confounding, because we know autism, ADHD, and other neurodevelopmental disorders are highly heritable.”
In 2014, Dr. Lee co-authored a significant study that examined the health records of 2.5 million children born in Sweden. Initially, a minor positive association was observed between acetaminophen use in mothers and the occurrence of autism, ADHD, and intellectual disability. However, this link vanished after a follow-up analysis compared siblings from the same mothers.
The sibling study’s results suggested that “maternal genetics,” rather than acetaminophen, could be the underlying cause.
Pregnant women are already encouraged to take folic acid early in pregnancy for healthy fetal brain development. Leucovorin, which the Health Department report is expected to recommend, is a form of folic acid.
Preliminary studies have also hinted that folic acid supplementation might enhance behavioral outcomes, such as communication skills, in children with autism.