New Study Questions Safety of Acetaminophen in Pregnancy for ADHD Risk

Study Links Prenatal Acetaminophen Use to Increased ADHD Risk in Children

Acetaminophen, commonly found in medications like Tylenol, is frequently used by pregnant individuals to relieve pain or reduce fever. Classified as safe during pregnancy by regulatory agencies such as the U.S. Food and Drug Administration (FDA), acetaminophen is often considered one of the only over-the-counter pain-relievers deemed safe for use during pregnancy. However, a recent study raises concerns about the potential long-term effects of prenatal exposure to acetaminophen, suggesting a possible link to Attention-Deficit/Hyperactivity Disorder (ADHD) in children.


The Study

The new research, published in Nature Mental Health, highlights the growing body of evidence that prenatal acetaminophen exposure may lead to adverse neurodevelopmental outcomes, including ADHD and autism spectrum disorders. The study tracked 307 pregnant women from 2006 to 2011, measuring acetaminophen biomarkers found in blood samples taken during pregnancy. The children born to these women were followed for 8 to 10 years, with the rate of ADHD assessed.

The study revealed a concerning finding: children born to mothers who used acetaminophen during pregnancy had an 18% rate of ADHD, while children of mothers who did not use acetaminophen had only a 9% rate of ADHD. In essence, prenatal acetaminophen exposure appeared to nearly double the likelihood of a child developing ADHD.

Mechanism of Exposure

The study found acetaminophen metabolites in the plasma samples of 20.2% of the mothers. Children whose mothers had detectable biomarkers for acetaminophen exposure were 3.15 times more likely to be diagnosed with ADHD compared to children of mothers without detectable acetaminophen levels. Interestingly, the association between acetaminophen use and ADHD was stronger in daughters than in sons, with daughters showing a 6.16 times higher likelihood of developing ADHD. However, the reasons for this gender difference remain unclear.

While acetaminophen is often recommended for pain relief during pregnancy, the study raises questions about its safety, particularly when compared to other alternatives such as ibuprofen, which carries greater risks for the fetus. The research suggests that doctors should reconsider the routine prescription of acetaminophen during pregnancy, especially in light of emerging evidence about its potential risks to neurodevelopment.

Conflicting Evidence

The research findings add to the ongoing debate regarding the safety of acetaminophen use during pregnancy. While many health professionals consider it a low-risk option for pain and fever management, recent studies have raised alarms about its potential links to long-term cognitive and behavioral issues in children. However, it is worth noting that the findings on this subject are not universally consistent.

For instance, a study in Sweden found no significant link between prenatal acetaminophen use and ADHD in children, though this study relied on self-reported data, which can be inaccurate. Another study conducted in Norway did find a link, though both studies highlight the need for more rigorous research with better data collection methods.

Calls for Reevaluation

The study's findings have led many researchers to call for a reevaluation of acetaminophen's safety during pregnancy. Though acetaminophen has been widely considered a safe and effective pain reliever, it was approved decades ago without the benefit of modern research into its long-term effects on fetal neurodevelopment. Given the growing body of evidence pointing to potential risks, it may be time for regulatory agencies such as the FDA to reassess its safety profile during pregnancy.

In the meantime, doctors and pregnant individuals should have an open conversation about the use of acetaminophen, including discussions about appropriate dosage and alternative pain management options. While acetaminophen is often the go-to choice for pain and fever relief during pregnancy, this study suggests that it may be prudent to consider other options or use acetaminophen only when absolutely necessary.

Study Reference: https://www.nature.com/articles/s44220-025-00387-6

What Should Pregnant Individuals Do?

With the growing body of research suggesting a link between acetaminophen use and ADHD, pregnant individuals may understandably feel confused about what steps to take. While acetaminophen is generally considered safe, especially compared to other pain relievers, it is important for pregnant individuals to discuss pain management strategies with their healthcare providers. Understanding the risks and benefits of any medication during pregnancy is essential, and there may be other, safer alternatives for managing pain, such as triptan medications for migraines.

For those concerned about the potential risks, it may be helpful to explore non-drug pain relief strategies or minimize the use of acetaminophen to the smallest dose and shortest duration necessary. More research is needed to fully understand the long-term effects of prenatal acetaminophen exposure, but for now, the best course of action is to remain informed and make decisions in consultation with healthcare providers.

Conclusion

This new study offers compelling evidence suggesting that prenatal acetaminophen exposure may increase the risk of ADHD in children, particularly in females. Though the study does not claim definitive causality, it adds to growing concerns about the long-term neurodevelopmental effects of this commonly used medication. As more research emerges, it will be essential for both healthcare providers and expectant parents to weigh the risks and benefits of acetaminophen use during pregnancy. Until clearer guidelines emerge, ongoing discussion and caution are key.