Acetaminophen Linked to ADHD & Autism From Use During Pregnancy

Autism and ADHD, two neurodevelopmental disorders which generally begin during childhood, have remained frequent subjects in news stories and informational articles over the past several years. Statistics reveal that about 1 in 44 children in the United States is diagnosed with autism spectrum disorder, also known as ASD, by the age of 8. Much more frequently, nearly 9 percent of U.S. children have ADHD, which is short for attention deficit hyperactivity disorder. 

As these numbers have continued to rise over the past decades, researchers have been looking into prenatal factors to hopefully uncover an explanation. In what may be surprising results, 26 different studies have uncovered a positive connection between neurodevelopmental disorders in a child and exposure during pregnancy to a common over-the-counter pain reliever. That pain reliever, acetaminophen, is commonly known by the drug name Tylenol. 

As it turns out, Tylenol is the most commonly recommended drug for pregnant women in need of pain relief and fever reduction, especially as an alternative to non-steroidal anti-inflammatory drugs such as Advil. Tylenol is manufactured by McNeil Consumer Healthcare, a subsidiary of Johnson & Johnson. Generic acetaminophen is also known throughout the world as paracetamol. Let’s look at some specifics of these neurodevelopmental disorders and how emerging research has uncovered a correlation between them and the use of acetaminophen during pregnancy. 

ADHD, or attention deficit hyperactivity disorder, is a neurodevelopmental disorder that’s usually diagnosed during early childhood and can continue into adulthood. While children may normally have difficulty focusing from time to time, the issue doesn’t improve in children with ADHD and may, in fact, get worse. Symptoms of ADHD include difficulty paying attention, poor impulse control, frequent daydreaming, forgetfulness, excessive talking, difficulty getting along with others, and frequent careless mistakes. 

A 2014 study from the Journal of the American Medical Association demonstrated a 20 to 30 percent increase in neurodevelopmental disorders, especially ADHD, when pregnant mothers used acetaminophen, especially if used during more than one trimester. A 2021 European Journal of Epidemiology study found that children prenatally exposed to acetaminophen were 19 percent more likely to have ASC (autism spectrum conditions) and 21 percent more likely to have ADHD symptoms. Johns Hopkins funded a study that discovered the highest levels of prenatal exposure to acetaminophen increased the risk for ADHD 2.86 times compared to children with the lowest levels of exposure. This study found an overall 25 percent increase in the onset of ADHD. 

The FDA, the U.S. Food and Drug Administration, has formally acknowledged the link between ADHD and prenatal exposure to acetaminophen. Autism spectrum disorder, or ASD, is a brain development disorder that affects how a person perceives the world. It often manifests as difficulties with social interactions and daily functioning. 

Symptoms occur on a spectrum ranging from mild to severe, including social withdrawal and resistance to physical contact, robot-like or sing-song speech, poor eye contact, and lack of facial expression; repetitive movements such as rocking; self-destructive activities like biting or head banging; unusual sensitivity to light, sounds, or touch; indifference to pain or temperature; abnormal concentration or fixation on objects or details; difficulty with coordination; stiff or exaggerated body language; repeating words or phrases without understanding them. 

Depending on the severity, some children may outgrow some symptoms, but those with severe cases could experience permanent disability. According to a study involving 70,000 children, exposure to acetaminophen during pregnancy is linked to a 19 percent increase in ASD risk. Children with the highest levels of prenatal acetaminophen exposure had a risk 3.62 times higher than children with the lowest levels of exposure. 

That being said, there are no 100 percent safe medications when taken during pregnancy. The FDA still warns pregnant women against taking ibuprofen, naproxen, or other NSAIDs after the 20th week of pregnancy, which means Tylenol is still regarded as the safest option despite the emerging evidence of neurodevelopmental risks for the baby. 

Of course, there are still steps to take to reduce the risk while pregnant. Most importantly, communicate with your physician to weigh the risks and benefits. In some cases, leaving a condition untreated can pose more serious risks to a developing fetus than acetaminophen or other medications. That means that sometimes taking medication is unavoidable. 

Follow these guidelines to help protect your baby when medication is necessary: limit the use of acetaminophen to when it is medically necessary, use the lowest effective dose available and for the shortest time possible, and consult your physician before using acetaminophen long-term. All patients have the right to be fully informed about the risks and benefits of any treatment they receive. 

This is called informed consent. A pregnant woman has to manage the health of two people, herself and her baby which makes informed consent all the more important. When drug makers and physicians recommend products without informing pregnant women of the potential risks, they can cause irreparable damage. They, not you, are responsible for any resulting harm. 

If you took acetaminophen because your doctor assured you it was safe but your child has developed ASD or ADHD, you may have legal recourse. The Birth Injury Center will post regular updates as the FDA continues to monitor and evaluate the use of Tylenol and other pain medications during pregnancy. You can find these and other abundant resources at BirthInjuryCenter.org