Acetaminophen use during pregnancy linked to ADHD risk

Acetaminophen is a common pain reliever that is also known as paracetamol. It is used for treating headaches, fevers, backaches, and other mild to moderate pains.

Many people take Tylenol without even realizing that its active ingredient is acetaminophen.

However, recent findings have raised concerns about the safety of acetaminophen, particularly its potential link to childhood ADHD – prompting questions about its use during pregnancy.

Acetaminophen and ADHD risk

A new study from the Seattle Children’s Research Institute has produced evidence that suggests acetaminophen usage during pregnancy could potentially increase the likelihood of offspring developing attention-deficit/hyperactivity disorder (ADHD).

Acetaminophen is among the most frequently prescribed drugs during pregnancy, with an estimated 41–70% usage reported in pregnant individuals in the United States, Europe, and Asia.

Despite being identified as low risk by regulatory agencies such as the FDA, research has indicated a potential link between exposure to acetaminophen during pregnancy and neurodevelopmental disorders, such as ADHD and autism spectrum disorder, noted the researchers.

Acetaminophen needs to be reevaluated

Study lead author Brennan Baker works in the lab of Dr. Sheela Sathyanarayana at UW Medicine.

Baker pointed out that past studies had depended on the self-reported data from women and thus may not have reflected acetaminophen use accurately. He also noted that the drug’s widespread use has long gone unquestioned.

“This medication was also approved decades ago and may need reevaluation by the FDA,” said Dr. Sathyanarayana. “Acetaminophen was never evaluated for fetal exposures in relation to long-term neurodevelopmental impacts.”

To get a clearer picture, the recent study involved tracking a group of 307 women between 2006 and 2011. Each of these expectant mothers agreed to provide blood samples, which allowed researchers to monitor acetaminophen biomarkers in their plasma.

Likelihood of ADHD diagnosis

The results of the analysis showed that children born to mothers who used no acetaminophen throughout their pregnancy had a 9% prevalence of ADHD. This rate increased to 18%, however, in the children of mothers who had used the drug.

Furthermore, the likelihood of an ADHD diagnosis was more than three times greater in children whose mothers carried acetaminophen biomarkers in their plasma.

Interestingly, the researchers identified a gender difference in these findings. They determined that a daughter’s risk of developing ADHD was more than six times greater if the mother had taken acetaminophen during pregnancy. The correlation was less pronounced and insignificant among sons.

Further research is needed

While this study does provide some insight, Baker warned against jumping to conclusions. Previous studies have provided inconsistent results.

For example, a Swedish study identified no correlation between mothers who took acetaminophen and the occurrence of ADHD in children, while a counter study in Norway did identify a correlation.

A key factor here is the data gathering process. The Swedish study was based on self-reported data, which showed that only 7% of pregnant women reported taking acetaminophen.

Baker noted that this factor may have resulted in underestimation of exposure. He emphasized the need for more detailed research.

Acetaminophen use during pregnancy

What should a concerned expectant mother do? The best approach is open communication with a healthcare provider. Pregnant women should consult their doctor to determine a safe and appropriate dosage of any type of medication.

Furthermore, other classes of drugs, such as triptans, are known to be effective and safe to treat the pain and migraines of expectant mothers during pregnancy.

While acetaminophen remains a crucial pain reliever, it is important to use it with caution and consider individual tolerance levels. As the medical community awaits further confirmation from global studies, regulatory authorities should update their guidelines accordingly.

“Medical societies and the FDA should update guidance on the use of acetaminophen as safety data emerges,” said Dr. Sathyanarayana.

The discussion around acetaminophen use during pregnancy continues to evolve. Now more than ever, it’s essential for expectant mothers to have open conversations with their doctors to make well-informed decisions for their baby’s health.

The full study was published in the journal Nature Mental Health.

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