“Tylenol (acetaminophen) in pregnancy causes autism”
You’ll see headlines and political statements linking Tylenol and autism. Medical consensus hasn’t shifted: recent government-adjacent claims are not aligned with the strongest epidemiology or with OB
The headline screams: Tylenol causes autism. The lawsuit banners, the cable chirons, the noise. But pause the feed and look closer.
The strongest study, millions of children in Sweden, found that once you strip away family genetics and the reasons people take Tylenol in the first place, the supposed link disappears. The correlation melts. The phantom shrinks.
Medical bodies still say what they’ve said for decades: acetaminophen is the safest first-line option in pregnancy when used properly. Not harmless, not magic, but safer than the fevers and infections it often treats.
So why does the claim linger? Because it carries weight in the culture war. Autism becomes a weapon, science a pawn. Lawsuits circle, headlines churn, and fear does what fear always does: it sticks.
What the best evidence says
Largest high-quality study to date (Sweden, ~2.48M children): small associations show up in basic models, but when researchers compared siblings (which controls for a lot of genetic and family confounders), the link disappeared for autism, ADHD, and intellectual disability (HRs ≈ 0.98–1.01). Translation: the signal looks like confounding, not causation.
Medical orgs’ position (ACOG, SMFM, others): Acetaminophen remains the safest first-line option for pain/fever in pregnancy when used as directed; current evidence does not justify changing practice.
Regulatory/legal backdrop: The federal multidistrict litigation over “Tylenol causes autism/ADHD” was thrown out after the judge excluded the plaintiffs’ causation experts; appeals are pending, but the cases were dismissed due to insufficient scientific support.
Media fact-checks & syntheses: Roundups note observational studies have found modest associations at times, but these do not prove causation and are likely influenced by why the drug was taken (fever, infection, pain) and family/genetic factors.
Why some studies see a link
Observational designs can mix up cause and context. Reasons for taking acetaminophen (fever, infection, migraines, autoimmune pain) and familial genetics can both raise neurodevelopmental risks independent of the medicine. That’s exactly what the sibling-comparison study was built to address and once you control for those, the association vanishes.
Bottom line
The claim that acetaminophen causes autism is not supported by the strongest current evidence.
Major medical groups still recommend acetaminophen as the go-to for pain or fever in pregnancy, at the lowest effective dose for the shortest time, after discussing with your clinician. Untreated fever itself can harm pregnancy, so avoid blanket avoidance based on headlines.
If you’re pregnant and deciding what to do
Talk to your OB/midwife before taking any meds.
Use acetaminophen first for pain/fever; avoid NSAIDs unless your clinician specifically says otherwise.
If you find yourself taking it frequently or for long stretches, that’s a cue to loop in your clinician to look for underlying causes and alternatives.