Most OB/GYNs have long advised pregnant patients that it’s perfectly safe to take acetaminophen (Tylenol) for pain, headaches, and fever. But while many will still give the green light to take it, you’ll likely start to hear some additional precautionary counseling from your doctor or midwife. This is the result of a new study published in the journal JAMA Pediatrics, which found that women who took acetaminophen while pregnant (most notably in the highest amounts) were more likely to have a child with attention deficient hyperactivity disorder (ADHD).

Researchers from UCLA and Denmark interviewed approximately 64,000 women in the Danish National Birth Cohort during and after their pregnancies to inquire about acetaminophen use. They then followed up when the babies were 7 years old. They determined that children whose mothers took the drug while pregnant were anywhere from 13 to 50 percent more likely to be treated for ADHD or exhibit ADHD-like behaviors than those whose mothers didn’t. This link was directly related to the duration of use, with the highest risk found in moms who took the drug for over 20 weeks in their pregnancy.

Before you jump to the conclusion that acetaminophen causes ADHD, it’s important to understand that this study only revealed an association; no one knows whether there’s truly a cause-and-effect relationship. For example, was it having a fever that caused this increased ADHD risk as opposed to the medication used to treat the fever? Even the study authors note that additional research is needed, though they theorize that the drug might disrupt hormones that play a role in fetal brain development.

Additionally, the research reflected that some of the women used Tylenol in relatively large quantities — with a term pregnancy lasting 40 weeks, taking Tylenol for 20 weeks means they used that medication daily for half their pregnancy.

For now, moms-to-be should remember to consult their provider before taking any medication, including over-the-counter preparations. But don’t be surprised if your doctor still says that acetaminophen is the safest pain reliever available as other drugs such as ibuprofen have a more concerning safety profile.

If you have a fever, treating it is likely much safer than avoiding Tylenol as we know for sure fevers can cause pregnancy complications (especially earlier in pregnancy). But for routine aches and pains, try non-pharmacological remedies such as rest, hydration, baths, massage, exercise, and yoga first. If you are still having issues, then consider moving on to medication, but check with your provider.

Sources:

• American Family Physician
• Over-the-Counter Medications in Pregnancy.
  JAMA Pediatrics
• Acetaminophen Use During Pregnancy, Behavioral Problems, and Hyperkinetic Disorders.
  JAMA Pediatrics
• Antenatal Acetaminophen Use and Attention-Deficit/Hyperactivity Disorder: An Interesting Observed Association But Too Early to Infer Causality.
  UCLA Newsroom
• Use of Acetaminophen During Pregnancy Linked to ADHD in children, UCLA Researchers Say.

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