Acetaminophen is widely trusted as a safe option for pain relief and fever reduction in pregnant women. However, the drug remains the subject of ongoing scientific debate regarding its potential long-term effects on the health of both mother and fetus.
Two new studies have revealed that the use of acetaminophen, commercially known as Tylenol or paracetamol, during pregnancy is not linked to an increased risk of children developing autism or ADHD, but it may cause changes in the development of the reproductive organs in infant girls, which could affect their future fertility.
In a Chinese study published in JAMA Internal Medicine, researchers from the Hong Kong Hospital Authority analyzed two decades of electronic health records for more than 124,000 children to identify pregnancies in which mothers were prescribed acetaminophen. They found that 3,445 of the 124,333 children (2.8%) were diagnosed with autism, and 5,168 of the 97,285 children (5.3%) were diagnosed with attention deficit hyperactivity disorder (ADHD).
The researchers found no association between prenatal acetaminophen use and either disorder, even when considering different gestational periods or frequency of use.
They concluded that "paracetamol remains a safe and essential analgesic and fever reducer during pregnancy, while alternatives such as NSAIDs and opioids carry documented risks." The researchers cautioned that mothers' reluctance to use acetaminophen for fever or severe pain could lead them to unsafe alternatives or cause complications such as birth defects, premature birth, and miscarriage.
Second study: Possible changes in the reproductive organs
A Danish study published in the journal Human Reproduction Open, which assessed 685 pregnant women and 302 infant girls, found that three-month-old girls who had been exposed to acetaminophen in utero had, on average, a 40% smaller ovarian volume, a 13% smaller uterine volume, and 23% fewer ovarian follicles, along with lower levels of reproductive hormones.
Dr. Margit Bistrup-Fischer, the study's lead author, said, "Animal studies have shown that impaired ovarian follicle formation can lead to reduced fertility and premature reproductive aging, but it remains unknown whether the differences observed in our study have implications for fertility and the age of menopause in humans." She emphasized that the study found associations, not a direct causal relationship, and that mothers who used acetaminophen during pregnancy "should not panic" and should discuss its use with their doctors.
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