A large-scale study published in JAMA Internal Medicine found no link between acetaminophen use during pregnancy and a risk of autism or attention-deficit/hyperactivity disorder (ADHD) in children. Researchers analyzed health records for more than 700,000 pairs of mothers and children, concluding that maternal use of the medication does not correlate with long-term neurodevelopmental outcomes, reinforcing its status as the first and safest choice for pain and fever during pregnancy.
Large-Scale Evidence on Acetaminophen Safety
A study covering two decades of electronic health records from Hong Kong indicates that acetaminophen, known as Tylenol in the United States, does not pose a risk of autism or ADHD in children. The research, published on June 29 in JAMA Internal Medicine, examined more than 700,000 pairs of mothers and children.
To account for the fact that both ADHD and autism are largely influenced by genetics, researchers compared siblings born to mothers who had taken the drug at some point, such that some siblings were exposed to the drug in utero and others weren’t. If acetaminophen were a factor, researchers would expect a difference between siblings exposed to the drug and those not. The data showed no such difference.
Why Sibling Comparison Matters
The analysis tracked children for at least two years for autism diagnoses and at least five for ADHD. The findings align with similar analyses conducted in Sweden and Japan, which also report no association between acetaminophen use in pregnancy and long-term neurodevelopmental disorders in children.
Clinical Guidance for Pregnancy
The American College of Obstetricians and Gynecologists recognizes acetaminophen as the first and safest choice for fever or pain relief during pregnancy.
Key Takeaways
- Scope: The study analyzed more than 700,000 pairs of mothers and children using data from 2001 to 2023.
- Methodology: The use of sibling-control analysis accounts for the fact that both ADHD and autism are largely influenced by genetics.
- Findings: No association was found between the timing, dose, or frequency of acetaminophen use during pregnancy and a child’s risk of autism or ADHD.
- Expert Consensus: Acetaminophen is the first and safest choice for fever or pain relief during pregnancy, according to the American College of Obstetricians and Gynecologists.
Addressing Public Concerns
In 2025, the Trump administration, without evidence, impugned the safety of the drug at a news briefing that included inaccurate information about autism. Pregnant individuals should continue to consult with their obstetricians regarding any medication use to ensure it is appropriate for their specific health needs.