This week the U.S. Department of Health and Human Services (HHS) announced the claim linking acetaminophen use in pregnancy and adverse neurodevelopmental outcomes. Professional organizations, such as the American College of Obstetricians and Gynecologists, are voicing their opposition to these claims. Molly Uhing, MD, FACOG with Avera Obstetrics & Gynecology provides more insight and clarity for concerned pregnant patients.
What do expecting mothers need to know about acetaminophen use in pregnancy?
Probably the most important thing is that autism and Tylenol have been looked at for over 20 years in several studies. This is something that is new right now and it's hot politically, but this is a long-standing thing in obstetrics and a link between the two has never been shown. Our job as providers is really about trying to help people reduce their risk as best as we can. So if you're having a perfect pregnancy, everything is going great and you can avoid all medication, we support that. But if you're sick and you have a fever, we don't want you to have a fever, THAT is worse than taking Tylenol (acetaminophen). Tylenol is the safest choice for fever reduction, it's the safest choice for headache, it's the safest choice for pain. And so if you're not comfortable yourself with this, reach out to your physician, talk to them to figure out what's best for you. But as a general rule, that's what the American College of OB/GYN is saying.
Can other pain medications be used instead of acetaminophen?
The three fever reducers that we all know that are available to all people are Tylenol, aspirin and ibuprofen. We absolutely know that ibuprofen is not safe in the second half of pregnancy. It can cause some early closure of some valves in the heart. It can cause low amniotic fluid around the baby, so it is 100% not recommended ever. We also don't recommend aspirin at high doses to reduce fever. We use aspirin at low doses for other things in pregnancy like prevention and reduction of preeclampsia, but neither of those two things are recommended for fever reduction. Because of this, the only safe option we have safe is Tylenol. We also go so far as to take that into the treatment of fever in children. We don't recommend aspirin being given to children at all, and so Tylenol and ibuprofen for children are going to be your safe choices. If you have any questions or concerns, reach out to your child's pediatrician and ask further questions, but in general, we wouldn't want people to automatically move away from Tylenol to something else based on what the government is saying, because those are well proven to not be good choices.
What message do you hope moms take away from this?
I would say the number one thing I want pregnant moms to take away from this is: I want them to take a deep breath and not panic. I want them to feel calm. Nothing has changed. If you have questions about medicine, reach out and ask your doctor. But do not feel bad at all about what you're putting in your body. You're doing a great job and you're growing your baby the best way that you absolutely can. For parents of children who have autism spectrum disorders, please do not feel guilty or look back on your pregnancy and worry that you did something to cause this. Autism is a complex neurologic disorder. There are thousands and thousands of really smart neuroscientists studying it all over the world and have been for 20 years. We know there's over 100 genes that are tied with it. We know that it is very strongly genetic. So please do not think about one time that you took Tylenol and feel bad.
Learn more about pregnancy guidelines and care for moms and babies
