From the Guidelines
Yes, acetaminophen use during pregnancy may affect infant neural development, with evidence suggesting a potential link to neurodevelopmental disorders such as ADHD and ASD 1.
Key Findings
- A review of 29 studies found positive associations between maternal acetaminophen use and adverse neurodevelopment effects, including ADHD, ASD, decreased IQ, and conduct disorders in 26 out of 29 studies 1.
- Another review found significant associations between maternal prenatal acetaminophen use and ADHD outcomes, with a potential dose-dependent relationship 1.
- The evidence suggests that minimization of prenatal acetaminophen exposure may be necessary to reduce the risk of ADHD outcomes 1.
Mechanisms and Associations
- Acetaminophen may act as an endocrine disruptor, leading to hormonal disruption and increased risk of neurodevelopmental disorders 1.
- The exact mechanisms underlying the association between acetaminophen use and neurodevelopmental outcomes are not fully understood and require further research 1.
Clinical Implications
- The findings of these reviews suggest that clinicians should exercise caution when recommending acetaminophen use during pregnancy, particularly in light of the potential risks to infant neural development 1.
- Further research is needed to fully understand the relationship between acetaminophen use and neurodevelopmental outcomes, as well as to inform clinical guidelines and practices 1.
From the Research
Acetaminophen Use and Infant Neural Development
- The use of acetaminophen (Tylenol) in infants has been widely believed to be safe, but recent studies suggest that early life exposure to acetaminophen may cause long-term neurodevelopmental problems 2.
- A systematic review of literature found that while acetaminophen is known to be safe for the pediatric liver, it was never shown to be safe for neurodevelopment, with a median follow-up time of only 48 hours in studies assessing safety 2.
- Animal models have demonstrated that cognitive development is sensitive to acetaminophen exposure during early development, and that therapeutic doses of acetaminophen can result in long-term behavioral changes in laboratory rats, even when combined with antioxidants to prevent oxidative stress 3.
Neurodevelopmental Risks
- Exposure to acetaminophen during early development has been linked to an increased risk of autism spectrum disorder (ASD), with some studies suggesting that nearly ubiquitous use of acetaminophen during early development could be responsible for the induction of a majority of ASD cases 4.
- Prenatal exposure to acetaminophen has also been associated with attention-related problems in early childhood, particularly when exposure occurs during the second trimester of fetal development 5.
- A review of observational studies found that prenatal paracetamol exposure was associated with an increased risk of neurodevelopmental outcomes, including ADHD, ASD, and lower IQ, with longer duration of use increasing the risk 6.
Key Findings
- The current evidence suggests that acetaminophen use in infants and children may pose a risk to neurodevelopment, particularly when used during critical periods of development 2, 3, 4, 5, 6.
- Further studies are needed to fully understand the relationship between acetaminophen use and neurodevelopmental outcomes, but caution is advised when considering the use of acetaminophen in the pediatric population 2, 4, 6.