Experts in Maine say Tylenol safe for pregnant women

AUGUSTA – Experts in Maine, including the director of the Maine Center for Disease Control and Prevention, are weighing in on comments made by the Trump Administration earlier this week linking the use of Tylenol by pregnant women to autism.

While no one directly contradicted Trump, the prevailing opinion is that there is little evidence to support his claims.

“We know, and the FDA agrees, that there is no causal link or causal association between acetaminophen and autism,” said Maine CDC Director Dr. Puthiery Va.

On Monday, the president held a press conference where he encouraged pregnant women to avoid taking acetaminophen, the active non-aspirin pain-relieving ingredient in Tylenol. 

“Taking Tylenol is not good,” he said. 

The FDA also announced Monday plans to mandate safety notices on bottles of Tylenol. 

The FDA also acknowledged that “acetaminophen is often the only tool for fevers and pain in pregnancy,” and Trump did suggest pregnant women consult with their doctors about use of acetaminophen. 

Still, the administration’s comments have generated responses nationwide and in Maine from health care and behavioral experts who say there is no real evidence to support advice to avoid taking Tylenol. 

“We don’t have strong evidence to suggest a direct relationship between the appropriate use of acetaminophen during pregnancy and harmful effects on the fetus,” said Dr. Melissa Bowker-Kinley, vice president of physician and APP services at MaineHealth Behavioral Health.

The FDA cited among its evidence studies such as one published in 2020 in the Journal of the American Medical Association Psychiatry. The study found that mothers of children later diagnosed with autism and attention-deficit-hyperactivity disorder did take acetaminophen while pregnant. 

The study suggested fetal exposure to acetaminophen was a factor in risk for development of autism and ADHD in children. Bowker-Kinley noted, however, that these studies show a correlation but don’t directly connect acetaminophen to autism.

“What the studies aren’t able to differentiate between is if the reason that the woman might have need to take the Tylenol, such as fever infection, if that also had its own impact on the fetal development,” she said. 

Va said that distinction is important, given the range of potential causes of autism.

“Why is a woman having to take Tylenol?” she said. “What’s driving that fever to begin with, and there are a lot of reasons behind that. It could be an infectious disease, it could be the health condition of the mom or parents themselves and even those conditions can put someone at a higher risk for developing autism including fever itself.”

Bowker-Kinley said autism spectrum disorder is a complex condition with a wide variety of potential causes. Genetics play a role, she said, but there is no single gene involved.

“Often it’s many, many genetic variations, each one contributing a small amount to the risk,” she said. 

Environmental factors can also increase the risk. Bowker-Kinley said these vary widely too, ranging from age of the parents to a lack of oxygen to the baby during birth to maternal obesity and diabetes to air pollution.

Right now, however, Bowker-Kinley said there is no evidence to definitively determine that acetaminophen causes autism.

“We don’t see data supporting a direct causative link at this point, and acetaminophen is still considered the safest option for treating pain and fever during pregnancy when used as directed,” she said.

As always, however, Bowker-Kinley said when in doubt, pregnant women should consult with their doctor before making any medical decisions. 

“So much of our decision-making is, we want to personalize to the patient and the family and we want to be able to make sure that it’s shared decision-making,” she said.

Va also encouraged pregnant women not to “tough it out,” and seek medical advice if they are not feeling well.

“You do not want to experience a fever without it being investigated or going untreated,” she said. “The harm to that is also very real.”