6/3/22, 10:58 AM Taking Tylenol during pregnancy associated with elevated risks for autism, ADHD | Hub

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Taking Tylenol during pregnancy

associated with elevated risks for autism,
ADHD
A Johns Hopkins study analyzing umbilical cord blood samples found that
newborns with the highest exposure to acetaminophen were about three
times more likely to be diagnosed with ADHD or autism spectrum disorder
in childhood

Hub staff report

/
 Nov 5, 2019
A new study from researchers at the Johns Hopkins Bloomberg School of Public Health has
found that exposure to acetaminophen in the womb may increase a child's risk for attention
deficit hyperactivity disorder or autism spectrum disorder.

The researchers analyzed data from the Boston Birth Cohort, a 20-year study of early life
factors influencing pregnancy and child development. They found that children whose cord
blood samples contained the highest levels of acetaminophen—the generic name for the drug
Tylenol—were roughly three times more likely to be diagnosed with ADHD or autism spectrum
disorder later in childhood, compared to children with the lowest levels of acetaminophen in
their cord blood.

Their findings were published last week in JAMA Psychiatry.

How do prenatal factors affect autism and other conditions?

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6/3/22, 10:58 AM Taking Tylenol during pregnancy associated with elevated risks for autism, ADHD | Hub

Previous studies have found an association between maternal use of acetaminophen during
pregnancy and increased risks of adverse childhood outcomes, including neurodevelopmental
disorders such as ADHD—which is marked by hyperactivity and difficulty paying attention or
controlling impulsive behavior—and autism spectrum disorder, a complex developmental
disorder that can affect how a person socializes, communicates, and behaves. Because these
studies relied on mothers self-reporting their acetaminophen use, critics have said the findings
may be affected by recall bias or lack an objective measure of in-utero exposure. As a result, the
U.S. Food and Drug Administration has refrained from making recommendations regarding the
use of acetaminophen during pregnancy.

"People in general believe Tylenol is benign, and it can be used safely for headaches, fever,
aches, and pains," says Xiaobin Wang, a professor in the Bloomberg School's Department of
Population, Family, and Reproductive Health and the study's corresponding author. "Our study
further supports the concerns raised by previous studies—that there is a link between Tylenol
use during pregnancy and increased risk for autism or ADHD."

For the study, which was authored by Johns Hopkins postdoctoral fellow Yuelong Ji and
colleagues, the team measured the biomarkers of acetaminophen and two of its metabolic
byproducts in umbilical cord blood samples from 996 individual births. Every sample analyzed
contained some level of acetaminophen—confirming the drug's widespread use during
pregnancy, labor, and delivery. The researchers then divided the study children into three
groups based on the amount of acetaminophen and its metabolites present in their cord blood
samples.

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Compared to the group with the lowest amount of acetaminophen exposure, the children in the
middle third group were about 2.26 times more likely to have an ADHD diagnosis and 2.14
times more likely to have an autism spectrum disorder diagnosis. Those with the highest levels
of exposure were associated with 2.86 times the risk of ADHD and 3.62 times the risk for
autism spectrum disorder, compared to those with the lowest exposure.

The researchers found consistent associations between the drug and the disorders across a
variety of other factors that correlate with ADHD and autism spectrum disorder diagnoses, such
as maternal BMI, preterm birth, child sex, and reports of maternal stressors and substance use.

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6/3/22, 10:58 AM Taking Tylenol during pregnancy associated with elevated risks for autism, ADHD | Hub

Wang points out that although the study found a consistent association between biomarkers of
acetaminophen and its metabolites in cord blood and child risk of ADHD and autism spectrum
disorder, it should not be interpreted that the Tylenol use causes these disorders.

"More studies are clearly needed to further clarify the concern," Wang says. "Until it is certain,
parents and providers may want to consider the benefit and potential risk when making a
decision on the use of acetaminophen during pregnancy or the peripartum period."

Posted in Health, Science+Technology

Tagged adhd, autism, child development, maternal health, newborns, population health

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