A recent study published by the Journal of Pediatrics links long-term prenatal use of acetaminophen (aka Tylenol) to ADHD in offspring.
Before you run to the medicine cabinet and ditch all your OTC pain-relieving drugs, take a few minutes to read this article and truly understand the research’s findings.
Study Lacks Definitive Evidence
Unlike the study, I’m going to start with the good news. In their own conclusion, the researchers admit that they “do not provide definitive evidence for or against a causal relation between maternal use of acetaminophen and ADHD.”
In a follow-up article on CNN.com, Dr. Alison G. Cahill, a member of the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice and not involved in the study, states simply that the research fails to “add anything to our medical knowledge.”
Cahill goes on to note the ‘design flaws’ in the study’s structure, which include the way ADHD is classified and diagnosed. Cahill points out that the “researchers calculated the number of children diagnosed with ADHD by codes in their medical records.”
“As you can imagine, there can be some disconnect between the making of that diagnosis and how it’s actually coded.” The symptoms of ADHD, for example, can be linked to many other related disorders.
The Numbers Don’t Support the Conclusion
Another expert in the field, Dr. Max Wiznitzer claims that the researchers failed to confirm the ADHD diagnoses and believes their codes may have merged in language and learning disorders.
“Women should not be afraid of using acetaminophen, especially if it’s their doctor’s recommendation,” he said. “The data here is not strong enough to support the conclusion.”
In response to Wiznitzer’s accusations, the study’s lead author and senior researcher at the Norwegian Institute of Health, Eivind Ystrøm defends the study’s findings and the claim that long-term prenatal acetaminophen use is linked to a higher risk of ADHD in offspring.
So, What Does the Study Say?
The research has a few notable findings relevant to expecting mothers and fathers.
- Long-term prenatal use, considered as 29 days or more, resulted in a 220% increase in risk of having a child born with ADHD.
- Long-term paternal prenatal use is “as strongly associated with ADHD as the corresponding maternal prenatal use*.”
- The symptoms that Tylenol is commonly recommended to combat and prevent, particularly fever, are also associated with neurodevelopmental problems, like ADHD.
*This finding is particularly peculiar considering the study also clearly notes that material preconception use is not associated with a higher risk of ADHD in offspring. In an attempt to support the data, Ystrøm suggested that general use of acetaminophen could be linked to a higher genetic risk for ADHD and may cause changes in sperm.
As a pregnant mother, how can using Tylenol affect my child?
According to the researchers, the acetaminophen crosses the placenta and can be traced in the infant’s urine following prenatal exposure. In an experiment using mice, their data shows that “neonatal exposure changes the levels of brain-derived neurotropic factor and results in altered behavior, lowered fear responses, and reduced learning abilities in adulthood.”
Skeptical Dr. Wiznitzer cautions against animal models. “It’s good to use the animal models as a first step, but you cannot automatically assume because it happens to the animal, it happens to humans,” he says. “I’ll guarantee these rodents are not getting the type of dose like you would take if you’re pregnant.”
An Impact on Brain Development
The study also claims that acetaminophen use “could interfere with maternal hormones (such as thyroid hormones and sex hormones)” that can affect brain development. And that the use “could interrupt brain development by induction of oxidative stress, leading to neuronal death.”
I think we can imagine what Wiznitzer would have to say about those brash allegations.
What if you took Tylenol during your pregnancy?
This article is not meant to provide individual medical advice and it’s recommended that if you have questions about your health to consult with a doctor, but based on preliminary research, you probably have little to worry about if you took Tylenol during your pregnancy.
Here’s the ‘good’ news: ADHD is most prevalently caused by familial and societal experiences and factors, including genetics—so, it’s most likely that your prenatal use of acetaminophen has not affected your child. If you really want to incite paranoia, try Googling “what causes ADHD in kids?”
Everything in Moderation
The study clearly notes the correlation of increased risk to number of days exposed, meaning that the more days the mother (or father) uses acetaminophen, the higher the child’s risk of having ADHD. In fact, the researchers suggest that use of less than 8 days could be beneficial for fetal development. I can just see Wiznitzer smirking at that.
But this is probably the point that underlines the most valuable result of the study: that everything is good in moderation, especially during pregnancy. Always be mindful about how often you take Tylenol and other medication and consider consulting your doctor if you have increased pain, fever, or other symptoms of discomfort. And most importantly, don’t ignore these symptoms in fear of taking Tylenol or similar medications. Trust your doctor and take all drugs as prescribed.