Acetaminophen and Pregnancy

There have been statements circulating in the health news related to autism in the past couple of weeks, and I want to provide some perspective on both. Today it’s about a link between autism and acetaminophen, the generic name for Tylenol, also known in other countries as paracetamol. Acetaminophen is also an ingredient in OTC meds such as Nyquil, Alka-Seltzer Plus, Theraflu, Goody’s Powder, Pamprin, and so on.

The controversy surrounds a recently published study that concluded pregnant women should use acetaminophen with caution under the supervision of a physician for short periods of time—which is exactly what the major medical associations already recommend.

The researchers used a statistical technique called navigation guide analysis. Essentially, it’s a meta-analysis typically used to assess environmental toxins; whether it should be used in a pharmacological analysis is not clear. In addition, there’s always the risk of bias when selecting studies for inclusion in any meta-analysis, and this is no different.

It’s especially difficult to ignore bias when three of the four researchers have provided expert evidence for plaintiffs in prior lawsuits against acetaminophen manufacturers. Even if that were not a concern, the methodology for assessing acetaminophen use depended on recall questionnaires from the mothers-to-be or their healthcare providers—not medical records. We know how well that works in Food Frequency Questionnaires, so let’s go: Did you take any pain meds in the last year? Which ones? Don’t remember? I’m not surprised—neither would I expect a woman who’s busy growing another person to remember every OTC med she took.

One more thing? Acetaminophen has been recommended for pain since the 1950s. If it were directly linked to the risk of autism or other neurological issues, it would have become apparent before this, some 75 years later. It doesn’t mean research shouldn’t continue, but for now, acetaminophen appears to be safe when taken as recommended for short periods of time under the direction of a physician. Pregnancy comes with a host of worries—which diapers, which car seat, which baby vitamins—but I’d take acetaminophen off that list.

On Saturday: is there a new treatment for autism?

What are you prepared to do today?