New research suggests that taking acetaminophen during pregnancy may be linked to a higher risk of autism and attention-deficit/hyperactivity disorder (ADHD) in children. The study, published this month in BMC Environmental Health, looked at previous research and found that the most reliable studies reported this risk, raising concerns about the drug’s use during pregnancy. ALSO READ: Medication safety during pregnancy Acetaminophen, also known as paracetamol and sold under brand names like Tylenol, is one of the most widely used over-the-counter medications globally. Studies indicate that between 40% and 65% of pregnant women use it to relieve headaches, fever, or other pain. For decades, it has been considered the safest available option for pain relief during pregnancy. The study found that acetaminophen passes through the placenta and may affect fetal development through processes such as oxidative stress and hormone disruption. While the findings do not prove that the drug causes neurodevelopmental disorders, they contribute to evidence of a link and show the need for careful use during pregnancy. Experts involved in the study recommended that pregnant women use acetaminophen only when necessary, for the shortest time possible, and under medical supervision. “Given the widespread use of this medication, even a small increase in risk could have important public health implications,” said Dr. Diddier Prada, one of the study authors. He added that expectant mothers should not stop taking prescribed medicines abruptly but instead discuss options with their healthcare providers. Emmanuel Ntidendereza, a pharmacist at Vine Pharma Ltd in Kigali, said that in Rwanda, acetaminophen is the only over-the-counter medication considered safe for pregnant and breastfeeding women to relieve fever and headaches when other options are ineffective. “Women are advised to take medicine only when necessary, and it should always be used at the correct dose under the guidance of a healthcare professional,” he said. Ntidendereza added that self-medication and frequent use without professional guidance should be avoided. “When taken according to recommended guidelines and doses, acetaminophen is considered safe. However, an overdose can cause liver damage, known as hepatotoxicity, in anyone, including pregnant women.” Although the research suggests a link between acetaminophen use during pregnancy and conditions like autism, Ntidendereza said the main concern is misuse. He explained that taking the medicine frequently or in high doses during pregnancy could affect fetal brain development; however, when used at the recommended dose and with guidance from a healthcare professional, acetaminophen is safe for pregnant women. “In Rwanda, paracetamol is sold under various brand names but contains the same active ingredient. Unlike prescription medicines, it can be purchased over the counter, and pharmacists often provide initial guidance to pregnant women on safe medication use. While some medications require a doctor’s prescription because tests are needed beforehand, paracetamol can be safely given without them,” the pharmacist explained. Pharmacists assess pregnant women’s conditions, provide guidance on safe medication use, and refer them to a hospital if specialized care is needed, he added.
