This investigation into medical myths is a guest post by Julia Beilis, medical student at Wright State University Boonshoft School of Medicine.
Pregnancy, although a time of excitement, is often accompanied by a heightened sense of responsibility. Each decision can feel like it carries long-term ramifications. The current presidential administration has fostered concern regarding a common and widely trusted medication: acetaminophen, known commonly as Tylenol. News headlines, social media, and political claims have suggested a tangible link between taking acetaminophen during pregnancy with an increased risk of autism spectrum disorder (ASD) in children.
For many patients, this raises an unsettling, but pressing question: Is this medication, long considered safe, now a potential risk for my future children?
The answer is not a simple yes or no. While some studies have suggested a potential association, current scientific evidence does not support a clear, causal relationship between Tylenol use during pregnancy and ASD. Understanding why requires a closer analysis at how these studies are conducted, as well as what their findings truly mean.
The Myth: “Tylenol Causes Autism”
The concern surrounding acetaminophen stems largely from highly publicized claims suggesting tangible causation between prenatal Tylenol exposure and neurodevelopmental conditions, particularly ASD.1
This narrative is alarming, as acetaminophen has long been recommended as the first-line option for managing pain during pregnancy. Acetaminophen lacks the potentially harmful effects that nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen pose to a growing fetus.2
Scientific studies frequently identify associations between variables but determining whether one actually causes the other requires a significantly higher standard of evidence. The leap from “correlation” to “causation” is significant but often misunderstood.
Why is this Question So Difficult?
Studying medication safety during pregnancy presents complicated ethical and scientific challenges. The gold standard for establishing causation is the randomized control trial (RCT), a type of study in which participants are randomly assigned to receive or avoid a treatment; however, RCTs are not feasible in the context of pregnancy due to requiring the assignment of pregnant individuals to take or avoid a medication with potential risks. This approach would understandably raise serious ethical concerns.
As a result, researchers will rely on observational studies and prior clinical data, both of which track real-world outcomes. While observational studies are valuable, these studies are limited by the presence of confounding variables—factors that can influence the exposure and outcome of a given study.
People take acetaminophen during pregnancy to treat fevers, infections, inflammation, or pain. These symptoms can stem from underlying conditions that themselves may be associated with harmful changes in fetal development. This makes it difficult to determine whether the observed outcome is related to acetaminophen use or the condition that led to taking the drug.
Additional challenges can include recall bias (where patients may inaccurately record medication use), dose variability (including distinctions in frequency, timing, and amount taken), genetic predisposition (which can influence neurodevelopmental outcomes), and environmental factors (such as socioeconomic status, access to adequate healthcare, and maternal health).
Because of these complexities, observational studies can identify patterns and generate important questions for future study, but they cannot definitively establish cause and effect.
What the Research Actually Shows
A large, nationwide observationalstudy initially found an association between acetaminophen use during pregnancy with an increased risk of ASD, ADHD, and intellectual disability.3 However, when researchers utilized more rigorous methods—such as sibling comparison analyses, which account for shared or similar genetic and environmental factors—this correlation lost its statistical significance.3.
Systematic reviews and meta-analyses allow for a broader perspective by including data across several studies. A recent meta-analysis reported a modest association between prenatal Tylenol exposure and neurodevelopmental disorders; however, the study emphasized a substantial flaw—the variability in the study design and the significant limitations in controlling for confounding variables.4
Similarly, a systematic review found inconsistent results across several research studies, noting that many patients were vulnerable to inherent biases and methodological limitations.5 An umbrella review, which serves as a “review of reviews” by evaluating multiple systematic reviews and meta-analyses, concluded that there is inadequate evidence to establish a tangible, causal relationship between prenatal acetaminophen use and neurodevelopmental disorders.6
Moreover, methodological critiques have highlighted how variance in study designs can significantly influence findings: how researchers measure exposure and account for confounding variables can mold results.
When we combine all this information, the current body of scientific evidence suggests that while correlations have been observed between Tylenol and ASD, they are weak, inconsistent, and likely influenced by factors outside of acetaminophen itself.
What Do Medical Experts Say?
The American College of Obstetricians and Gynecologists persist with their stance: acetaminophen remains one of the safest options for pain and fever relief during pregnancy when used appropriately.8 Their guidance and recommendations emphasize that current publications and data lack the clear causal relationship between acetaminophen use and adverse neurodevelopmental outcomes.
Similarly, the United States Food and Drug Administration (FDA) has reviewed available evidence and ultimately concluded that the available data is insufficient to determine whether acetaminophen increases the risk of developmental issues.9 The FDA advises that medication use during pregnancy should be used only as needed, while also in consultation with a patient’s healthcare provider.
These recommendations reflect a broader principle in medicine—decisions should be guided by the totality of available studies and evidence, rather than individual studies or claims in isolation.
Media, Misinformation, and Political Claims
Public concern surrounding acetaminophen has been amplified by media coverage and ongoing political claims and discourse. Headlines tend to simplify complex findings, and this can result in presenting potential associations as definitive proof. Over time, repeated exposure to these messages can shape our perception on this topic, despite evidence showing the contrary.
Public debates can further blur the line between scientific research, evidence, and public opinion. These discussions can raise awareness and allow for healthy discussion, but they can also contribute to confusion and anxiety among patients.
For patients, navigating this complex landscape can be overwhelmingly challenging. Conflicting messages from news outlets and social media can make it difficult to determine what research is reliable, and what is not.
What Should Patients Do?
In the face of uncertainty, it is completely understandable to feel anxious or overwhelmed. However, current research does not support avoiding acetaminophen altogether during pregnancy.
If acetaminophen is avoided, untreated symptoms may pose their own risks. For example, maternal fever has been associated with adverse pregnancy complications and issues regarding fetal development.10, 11 Severe or chronic pain can also impact overall maternal well-being, and this can translate to fetal well-being as well.
The goal is to not eliminate all potential risks; however, but for future parents to make balanced, informed decisions. Consulting with a healthcare provider before taking medications while pregnant allows patients to best align with current clinical recommendations, while also appropriately balancing the risks and benefits.
Reframing the Debate and Final Thoughts
The debate surrounding acetaminophen and ASD highlights a broader challenge in our healthcare system—how to interpret evolving research and evidence in a way that informs, not alarms, patients. Scientific research is an ongoing process. New studies raise questions, and can occasionally challenge previous assumptions. Uncertainty is not a failure of science and medicine; it is a cornerstone in how our knowledge evolves.
For patients, this means recognizing that not all associations automatically equate to causation. For clinicians, it underscores the significance of clear, compassionate communication to help their patients navigate complex medical information and dilemmas.
The idea that Tylenol use during pregnancy can cause ASD and other neurodevelopmental disorders is a concerning, yet powerful, claim. However, it is not supported by current scientific evidence. While some research studies have identified correlations, these findings are limited by significant methodological flaws and ultimately do not establish causation.
When viewed as a whole, scientific literature suggests that any potential relationship between acetaminophen and ASD is weak, inconsistent, and influenced by confounding variables. Major medical organizations and societies continue to support and recommend the use of acetaminophen during pregnancy when used appropriately and under medical guidance.
Ultimately, in an era of rapid, widespread information and misinformation, separating fact from fear is absolutely essential. Focusing on the evidence, context, and open communication between patient and provider allows us to make informed decisions with confidence and without unnecessary anxiety.
References
- Azeen Ghorayshi. Trump Issues Warning Based on Unproven Link Between Tylenol and Autism. The New York Times. https://www.nytimes.com/2025/09/22/health/kennedy-autism-tylenol-trump.html?searchResultPosition=2. Published September 22, 2025.
- Vignato J, Mehner B, Negrete A, Segre LS. Over-the-Counter Pain Medication Use During Pregnancy. MCN: The American Journal of Maternal/Child Nursing. 2023;48(4):209-214. doi:10.1097/NMC.0000000000000929.
- Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. JAMA. 2024;331(14):1205. doi:10.1001/jama.2024.3172.
- D’Antonio F, Flacco ME, Valle LD, et al. Prenatal paracetamol exposure and child neurodevelopment: a systematic review and meta-analysis. The Lancet Obstetrics, Gynaecology, & Women’s Health. 2026;2(3):e190-e198. doi:10.1016/S3050-5038(25)00211-0.
- Bérard A, Cottin J, Leal LF, et al. Systematic Review and Meta-Analysis: Acetaminophen Use During Pregnancy and the Risk of Neurodevelopmental Disorders in Childhood. Journal of the American Academy of Child & Adolescent Psychiatry. 2026;65(4):484-504. doi:10.1016/j.jaac.2025.09.031.
- Sheikh J, Allotey J, Sobhy S, et al. Maternal paracetamol (acetaminophen) use during pregnancy and risk of autism spectrum disorder and attention deficit/hyperactivity disorder in offspring: umbrella review of systematic reviews. BMJ. 2025;391:e088141. doi:10.1136/bmj-2025-088141.
- Blencowe H, Jayaratne K, Murewanhema G, Connery AK, Regan AK, Oakley LL. Method matters: prenatal paracetamol use and neurodevelopmental outcomes. The Lancet Obstetrics, Gynaecology, & Women’s Health. 2026;2(3):e168-e170. doi:10.1016/S3050-5038(26)00012-9.
- Acetaminophen Use in Pregnancy and Neurodevelopmental Outcomes. Acog.org. Published 2025. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2025/09/acetaminophen-use-in-pregnancy-and-neurodevelopmental-outcomes.
- FDA Has Reviewed Possible Risks of Pain Medicine Use during Pregnancy Safety Announcement. Accessed March 31, 2026. http://www.sefap.it/web/upload/FDA_farmaci_per_il_dolore_in_gravidanza.pdf.
- Goetzl L. Maternal fever in labor: etiologies, consequences, and clinical management. American Journal of Obstetrics and Gynecology. 2023;228(5):S1274-S1282. doi:10.1016/j.ajog.2022.11.002.
- Shi F, Huang Y, Dai Q, Chen Y, Jiang H, Liang SY. Maternal Common Cold or Fever During Pregnancy and the Risk of Orofacial Clefts in the Offspring: A Systematic Review and Meta-analysis. The Cleft Palate Craniofacial Journal. 2023;60(4):446-453. doi:10.1177/10556656211067695.