A Headline That Sparked Anxiety Among Parents
by Amelia Watkins, Ph.D., MS.
Headlines about a possible link between Tylenol (acetaminophen) use during pregnancy and autism have stirred up a lot of anxiety among parents. Social media posts amplified that fear, often pulling older studies out of context without explaining their limitations.
This isn’t the first time the concern has made headlines. The discussion gained momentum in 2021 after a group of scientists called for more research and advised limiting acetaminophen use in pregnancy to the lowest effective dose for the shortest time necessary (Bauer et al., 2021, Nature Reviews Endocrinology).
What Decades of Research Really Show
Acetaminophen is one of the most commonly used medications in pregnancy. Because of that, it has been studied for decades.
Some earlier observational studies suggested there might be a link between prenatal acetaminophen exposure and later diagnoses of autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) (Ji et al., 2018, American Journal of Epidemiology). But there’s a big catch: observational studies can’t prove cause and effect. Many of the conditions that lead to acetaminophen use, such as fever, infection, or significant pain, may themselves increase risks for neurodevelopmental challenges. (Hornig et al., 2018, Molecular Psychology)
The Latest 2025 Studies, Putting the Headlines in Context
Recent high-quality studies have helped clarify the picture:
- Sibling-controlled cohort study (JAMA, 2024): By comparing siblings, researchers could account for many genetic and family-level factors. This study found no increased risk of ASD, ADHD, or intellectual disability from acetaminophen use in pregnancy (Alhqvist et al., 2024, JAMA).
- Umbilical cord biomarker studies: Some earlier studies measured acetaminophen metabolites in cord blood and reported statistical associations with later ASD or ADHD (Ji et al., 2020, JAMA Psychiatry). These studies are important but can’t fully separate the effects of the drug from the reasons it was used.
- Narrative reviews (2025): A recent synthesis of multiple studies concluded that, while there is some evidence of association, there is no proof of a causal link and more high-quality studies are needed Prada et al., 2025. Environmental Health.
What Doctors and Public Health Agencies Are Saying
Leading health organizations have weighed in:
- The American College of Obstetricians and Gynecologists (ACOG) updated its guidance in 2025. ACOG stated that the most rigorous recent studies do not support a significant link between prenatal acetaminophen use and autism or other neurodevelopmental outcomes. Acetaminophen remains the preferred pain reliever in pregnancy when used as directed(ACOG Practice Advisory, September 2025).
- The World Health Organization (WHO) said in September 2025 that current evidence does not confirm a causal link and cautioned against avoiding treatment for fever or pain without medical advice (WHO, 2025 Statement).
Why Fever, Not Just the Medicine, Deserves Attention
Fever itself has been linked to increased neurodevelopmental risks in some studies. That is why doctors often recommend acetaminophen for high or persistent fevers during pregnancy. Avoiding treatment because of fear of the medicine can sometimes pose more risk than the drug when it’s used appropriately (Antoun et al., 2021, Molecular Autism.)
The Real and Often Overlooked Risk: Acetaminophen Overdose
While debate continues about autism, the well-established danger is overdose. Taking too much acetaminophen, often by unknowingly combining multiple products that contain it, can lead to serious liver damage or even liver failure (Rubin et al., 2017, Clinical Gastroenterology and Hepatology). This is why careful label-reading and sticking to recommended doses is essential.
Practical Steps for Pregnant Women and Families
Based on what we know today, here’s what major health agencies and most clinicians recommend:
- Talk with your healthcare provider before starting or continuing any medication during pregnancy.
- Use acetaminophen only when necessary, at the lowest effective dose for the shortest time needed.
- Read labels carefully to avoid doubling up on acetaminophen-containing cold or pain medicines.
- Seek emergency care immediately if you suspect an overdose.
- Don’t ignore persistent or high fever, discuss it promptly with your healthcare provider.
Where the Research is Heading Next
New research is focusing on better ways to separate the effects of acetaminophen itself from the effects of the underlying conditions that lead to its use. Studies are increasingly incorporating genetic factors, detailed tracking of maternal health conditions, and improved ways to measure exposures (Gustavson et al., 2021, ACAMH.)
The Bottom Line: Balance, Caution, and Context
The claim that Tylenol causes autism is not supported by the best available evidence. Stronger, better-controlled studies do not find an association, and experts agree that acetaminophen remains safe when used appropriately during pregnancy.
The goal is not to avoid all treatment but to use medications wisely, manage fever appropriately, and prevent accidental overdose.
Disclaimer: This article is for educational purposes only and should not replace personalized medical advice. Always consult your healthcare provider for guidance that takes into account your individual health and pregnancy.
References
ACOG. (2025, September 22). ACOG Affirms Safety Benefits Acetaminophen Pregnancy. https://www.acog.org/news/news-releases/2025/09/acog-affirms-safety-benefits-acetaminophen-pregnancy
Ahlqvist, V. H., Sjöqvist, H., Dalman, C., Karlsson, H., Stephansson, O., Johansson, S., Magnusson, C., Gardner, R. M., & Lee, B. K. (2024). Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. JAMA, 331(14), 1205–1214. https://doi.org/10.1001/jama.2024.3172
Antoun, S., Ellul, P., Peyre, H., Rosenzwajg, M., Gressens, P., Klatzmann, D., & Delorme, R. (2021). Fever during pregnancy as a risk factor for neurodevelopmental disorders: Results from a systematic review and meta-analysis. Molecular Autism, 12, 60. https://doi.org/10.1186/s13229-021-00464-4
Bauer, A. Z., Swan, S. H., Kriebel, D., Liew, Z., Taylor, H. S., Bornehag, C.-G., Andrade, A. M., Olsen, J., Jensen, R. H., Mitchell, R. T., Skakkebaek, N. E., Jégou, B., & Kristensen, D. M. (2021). Paracetamol use during pregnancy—A call for precautionary action. Nature Reviews Endocrinology, 17(12), 757–766. https://doi.org/10.1038/s41574-021-00553-7
Gustavson, K., Ystrom, E., Ask, H., Ask Torvik, F., Hornig, M., Susser, E., Lipkin, W. I., Lupattelli, A., Stoltenberg, C., Magnus, P., Mjaaland, S., Askeland, R. B., Walle, K. M., Bresnahan, M., Nordeng, H., & Reichborn-Kjennerud, T. (2021). Acetaminophen use during pregnancy and offspring attention deficit hyperactivity disorder – a longitudinal sibling control study. JCPP Advances, 1(2), e12020. https://doi.org/10.1002/jcv2.12020
Hornig, M., Bresnahan, M. A., Che, X., Schultz, A. F., Ukaigwe, J. E., Eddy, M. L., Hirtz, D., Gunnes, N., Lie, K. K., Magnus, P., Mjaaland, S., Reichborn-Kjennerud, T., Schjølberg, S., Øyen, A.-S., Levin, B., Susser, E. S., Stoltenberg, C., & Lipkin, W. I. (2018). Prenatal fever and autism risk. Molecular Psychiatry, 23(3), 759–766. https://doi.org/10.1038/mp.2017.119
Ji, Y., Azuine, R. E., Zhang, Y., Hou, W., Hong, X., Wang, G., Riley, A., Pearson, C., Zuckerman, B., & Wang, X. (2020). Association of Cord Plasma Biomarkers of In Utero Acetaminophen Exposure With Risk of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in Childhood. JAMA Psychiatry, 77(2), 180–189. https://doi.org/10.1001/jamapsychiatry.2019.3259
Prada, D., Ritz, B., Bauer, A. Z., & Baccarelli, A. A. (2025). Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology. Environmental Health, 24(1), 56. https://doi.org/10.1186/s12940-025-01208-0
WHO. (2025, September 24). WHO statement on autism-related issues. https://www.who.int/news/item/24-09-2025-who-statement-on-autism-related-issues