Review of 60 Studies Finds Tylenol Use in Pregnancy Does Not Raise Risk of Autism, Contrary to Trump Claims

When used as directed, acetaminophen, also known as paracetamol or Tylenol, does not  raise the likelihood of developmental disorders in children, according to a major review of dozens of studies published Friday.

Acetaminophen is widely recommended during pregnancy as a first-line option for managing pain or fever, although doctors generally advise using it in limited amounts.

Previous studies produced inconsistent results, with some suggesting a potential increase in autism or ADHD risk, leaving many expectant parents uncertain about the medication’s safety.

The new meta-analysis, published in The Lancet Obstetrics, Gynecology & Women’s Health, examined approximately 60 studies to evaluate the evidence.

The researchers concluded that when acetaminophen is used according to the label, there is no connection to developmental disorders, marking one of the most thorough evaluations on this topic to date.

“The clearest takeaway is that the best-quality evidence does not support a causal link between taking paracetamol during pregnancy and autism or ADHD in children,” Dr. Asma Khalil, study co-author and professor of obstetrics and maternal fetal medicine at St. George’s Hospital in London, told ABC News.

“Pregnant women should feel reassured that paracetamol remains the recommended first-line option for pain or fever in pregnancy when used as directed,” she added.

In September, President Donald Trump began claiming that acetaminophen use in pregnancy was “associated with a very increased risk of autism” and advised, “Don’t take Tylenol.” He has since repeated the advice many times.

The president has repeated the claim on social media, also suggesting that young children, including infants, should not be given acetaminophen, without providing evidence.

At the time, the Food and Drug Administration issued a note to doctors about a potential link between acetaminophen in pregnancy and autism, clarifying that no evidence confirms Tylenol causes autism and that the issue remains under scientific study.

HHS told ABC News that “many experts have expressed concern of the use of acetaminophen during pregnancy.”

Leading medical groups raised alarms that such claims could discourage pregnant women from using acetaminophen even when it may be beneficial.

Tylenol’s manufacturer, Kenvue, stated that research indicates acetaminophen does not cause autism.

In a new statement to ABC News, Kenvue said it would review the latest analysis. “Our view of the existing science remains the same: we believe independent, sound science shows Tylenol is safe and taking acetaminophen does not cause autism,” the company said.

The review emphasized sibling-comparison studies, which compare siblings born to the same mother, one exposed to acetaminophen in utero and one not. Because siblings share genetics and family environment, this approach helps distinguish the drug’s effects from other factors.

Across these analyses, acetaminophen exposure during pregnancy was not linked to autism, ADHD, or intellectual disabilities, even in studies tracking children for more than five years.

The researchers suggested this review may clarify why some earlier observational studies seemed to show a possible association between acetaminophen use and developmental disorders.

“People do not take acetaminophen randomly but for symptoms such as fever, infection, inflammation or pain,” the authors noted. These underlying conditions could influence fetal brain development, creating confusion about whether the drug or the symptom caused the outcome.

Jessica B. Steier, head of the science communication group Unbiased Science, said that leaving symptoms untreated, such as fever, could be harmful to both the pregnant person and the fetus.

“Untreated fever has documented associations with serious pregnancy and fetal risks,” she explained. “The alternative pain medications — NSAIDs, opioids — carry their own pregnancy risks. Acetaminophen remains the safest option when medication is needed.”

Steier also cautioned that studies linking acetaminophen to autism can be misleading, particularly when amplified on social media.

An HHS official told ABC News that the new analysis “does not resolve an important public health question; it sidesteps it. By excluding the vast majority of relevant evidence, privileging one study design known to bias results toward the null, and misrepresenting statistical power, the authors engineer a finding rather than evaluate causality.”

Khalil advised patients to use the lowest effective dose for the shortest duration and seek medical guidance if symptoms persist, worsen, or return — particularly fever.

The review does have limitations, including a small number of sibling-based studies, which made it difficult to account for other factors influencing both painkiller use and neurodevelopmental outcomes.

Still, the findings align with guidance from professional medical groups such as the American College of Obstetricians and Gynecologists (ACOG).

ACOG recommends using acetaminophen as needed, following label instructions, consulting a doctor when appropriate, and monitoring the symptoms prompting its use.

Persistent high fever, severe pain, or symptoms not improving during pregnancy may signal an underlying issue requiring medical attention, according to ACOG.

“It’s always sensible to use paracetamol appropriately in pregnancy: the lowest effective dose for the shortest time, and avoid unnecessary prolonged use without medical review,” Khalil said.