Clarifying Risks and Benefits of Acetaminophen in Pregnancy Amid Misleading Information

Recent statements have caused confusion and fear among expectant parents regarding the safety of acetaminophen, commonly known as Tylenol, during pregnancy. President Donald Trump's assertion that pregnant women should avoid Tylenol has led to widespread concern, despite clear guidance from medical authorities. As an obstetrician and researcher, I personally experienced the importance of acetaminophen during labor, when it helped reduce fever and lower my baby's elevated heart rate, ultimately contributing to a healthy delivery.

The American College of Obstetricians and Gynecologists has reaffirmed that acetaminophen is safe and effective for use during pregnancy. However, mixed messages have emerged from various studies linking acetaminophen use to neurodevelopmental conditions like ADHD and autism. These studies often highlight associations, but cannot definitively establish causation. Many of these research efforts are based on observational data, which can be confounded by factors such as the underlying illnesses prompting medication use, like fevers or infections.

Supporting this perspective, a comprehensive 2024 Swedish study involving millions of children found that the apparent increase in autism risk associated with prenatal acetaminophen exposure diminishes when sibling comparisons are considered, suggesting that genetic and environmental factors play significant roles.

Fever during pregnancy, however, is strongly associated with adverse outcomes. Elevated maternal temperatures, especially if recurrent or severe, can significantly increase the risk of autism and other developmental issues. Managing high fever in pregnant women with acetaminophen is a common and necessary strategy to prevent serious complications for both mother and child.

Pregnant patients often experience pain—from back pain, kidney stones, or dental issues—that require safe relief options. Acetaminophen remains the safest recommended medication, unlike NSAIDs, which can cause complications such as fetal heart defects or insufficient amniotic fluid, or opioids, which carry risks of dependency and withdrawal.

In the complex landscape of pregnancy care, providing evidence-based, nuanced information is vital. Misinformation can lead to unnecessary fear, delaying essential treatment. We owe it to future parents to ensure they receive honest, scientifically supported guidance to make informed healthcare decisions.