Major New Review Strengthens Evidence That Tylenol Does Not Raise Risk of Autism, Contradicting Trump Claims

A comprehensive new analysis of scientific studies has concluded that taking acetaminophen—the pain and fever reliever sold as Tylenol in the U.S. and paracetamol internationally—during pregnancy does not increase a child’s risk of autism, ADHD, or intellectual disabilities. The findings, published Friday in The Lancet Obstetrics, Gynecology & Women’s Health, add significant weight to a growing consensus refuting high-profile claims previously promoted by the Trump administration.

Former President Donald Trump last year publicly asserted an unproven link, directly advising pregnant women, “Don’t take Tylenol.” His administration’s online materials highlighted research suggesting a potential association, influencing public debate and causing concern among expectant parents.

The Latest Evidence
The new review, which synthesized data from 43 studies, determined that the most methodologically rigorous research shows no causal link. Studies that controlled for genetic and environmental factors by comparing siblings—a powerful design to isolate drug effects—provided particularly strong evidence of safety.

“It’s safe to use in pregnancy,” stated the review’s lead author, Dr. Asma Khalil, a fetal medicine specialist at St. George’s Hospital, London. “It remains … the first line of treatment that we would recommend if the pregnant woman has pain or fever.”

This publication follows other major reviews. A 2024 analysis in The BMJ found existing evidence did not clearly link prenatal acetaminophen use to neurodevelopmental disorders. Similarly, a 2023 sibling study in the Journal of the American Medical Association found no association with autism, ADHD, or intellectual disability.

Addressing the Contradictory Research
The White House webpage had cited a 2023 review in BMC Environmental Health that analyzed 46 previous studies and concluded they supported evidence of an association. The senior author of that review, Dr. Andrea Baccarelli, dean at Harvard T.H. Chan School of Public Health, disclosed in the paper that he had served as an expert witness for plaintiffs in litigation involving acetaminophen and neurodevelopment. Dr. Baccarelli did not respond to a request for comment on his study.

Experts like Dr. Khalil have raised methodological concerns about that earlier review, noting it included small studies and those prone to bias. They emphasize that an observed association in some research does not prove cause and effect.

The Role of Confounding Factors
Researchers explain that studies finding a small correlation often struggle to account for confounding factors. For instance, a pregnant person may take acetaminophen to treat a fever, and the fever itself—or the infection causing it—is a known risk factor for adverse neurodevelopmental outcomes. Separating the effect of the drug from the effect of the condition it treats is challenging.

“Research can also be affected by ‘recall bias,’” Khalil explained, “such as when the mother of an autistic child doesn’t accurately remember how much of the drug she used during pregnancy after the fact.” When studies use designs that minimize these confounders, she said, “the association is not seen.”

Experts stress that genetics are the largest known risk factor for autism. Other established risks include advanced paternal age, preterm birth, and certain maternal health conditions during pregnancy.

The Risk of Discouraging Necessary Treatment
An accompanying commentary from independent researchers at the London School of Hygiene and Tropical Medicine, Children’s Hospital Colorado, and other institutions warned that discouraging acetaminophen use carries significant public health risks.

They cautioned that inadequate treatment of pain or high fever in pregnancy poses “well-established risks to fetal survival and neurodevelopment.” Untreated maternal fever and infection can directly harm the fetus, making safe and effective fever management critical.

The consensus among leading obstetric and public health experts is clear: acetaminophen remains an essential, safe medication for managing pain and fever during pregnancy, and its proven benefits for maternal and fetal health far outweigh unsubstantiated risks. Patients with concerns are advised to consult their healthcare providers rather than forgo necessary treatment based on discredited claims.

 

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