The study, which reviewed approximately 60 existing research papers, marks one of the most rigorous evaluations of the drug to date. It specifically focused on "sibling-comparison" data—comparing children born to the same mother where the drug was used in one pregnancy but not another. This method allows researchers to filter out genetic and environmental factors that often skew observational data.
Addressing the Controversy
The findings arrive amid a heated public debate. Last September, President Donald Trump sparked concern by warning on social media that acetaminophen was linked to a "very increased risk of autism," advising pregnant individuals to avoid Tylenol. While the FDA noted at the time that the link was a matter of ongoing scientific debate, many major medical groups feared such rhetoric would scare patients away from necessary treatment.
Study co-author Dr. Asma Khalil, a professor at St. George’s Hospital in London, told ABC News that the most reliable evidence fails to show a causal connection between the drug and neurodevelopmental issues. She noted that pregnant individuals should feel confident using paracetamol as the primary treatment for pain or fever, provided they follow directed use. Why Previous Studies May Have Been Misleading
The review explains why some earlier studies suggested a connection. Acetaminophen is typically taken to treat fever, infection, or inflammation—conditions that themselves can impact fetal brain development. In many cases, the underlying illness, rather than the medication, may have been the contributing factor to developmental changes.
Experts warn that avoiding the drug entirely can be dangerous. Jessica B. Steier of Unbiased Science noted that "untreated fever has documented associations with serious pregnancy and fetal risks," and that alternatives like opioids or NSAIDs carry significantly higher risks.
Key Takeaways for Expectant Parents
- Safe Option: Acetaminophen remains the safest first-line choice for managing pain and fever during pregnancy.
- Follow the Label: Benefits are confirmed when the drug is used according to standard dosage instructions.
- Caution with Fever: A high or persistent fever can be more harmful to a fetus than the medication used to treat it.
- Best Practice: Dr. Khalil advises using the "lowest effective dose for the shortest amount of time" and consulting a doctor if symptoms persist.
While some officials at the Department of Health and Human Services (HHS) remain skeptical of the study's design, the findings align with the long-standing guidance of the American College of Obstetricians and Gynecologists (ACOG).
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