Can pregnant women give their unborn child ADHD by taking Tylenol?

If a pregnant woman takes acetaminophen, an ingredient found in pain relievers like Tylenol, Excedrin, and Panadol, her unborn child could develop attention-deficit/hyperactivity disorder (ADHD).

According to a study published Feb. 6 in Nature Mental Health reported by UW News, the findings suggest that doctors should reconsider prescribing medications with acetaminophen to mothers during pregnancy.

Prior research shows that upward of 70% of pregnant women use acetaminophen during pregnancy to control pain or reduce fever. The drug, which is the active ingredient of many pain-relief medications, is one of the few considered safe to take during pregnancy by the U.S. Food and Drug Administration (FDA).

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Acetaminophen is a common ingredient for pain relief

Acetaminophen is a common ingredient in over 600 different medications, both prescription and over-the-counter (OTC). Vicodin, Percocet, and Tylenol with Codeine are also over-the-counter medicines containing the pain reliever.

“Most of the prior studies asked women to self-report whether they had taken Tylenol or anything that contained acetaminophen,” Brennan Baker, a researcher at Seattle Children’s Research Institute, told UW News.

Acetaminophen is often used to treat mild to moderate pain, such as headaches, muscle aches, arthritis, and toothaches, and to reduce fever.

“This medication was also approved decades ago, and may need reevaluation by the FDA,” Dr. Sheela Sathyanarayana, a UW Medicine pediatrician, told UW News. “Acetaminophen was never evaluated for fetal exposures in relations to long-term neurodevelopmental impacts.”

The children born to 300 mothers who agreed to give blood samples during pregnancy were followed for 8 to 10 years. Among the women who did not use acetaminophen during pregnancy, the rate of ADHD was 9%, but for the women who used acetaminophen, the ADHD rate was 18%.

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New study suggests higher risk

Despite acetaminophen’s classification as low risk by regulatory agencies such as the FDA, new evidence suggests a potential link between prenatal acetaminophen exposure and adverse outcomes, like ADHD and ADHD autism spectrum disorder, the researchers noted.

The association was stronger among daughters than sons, with the daughters of acetaminophen-exposed mothers showing a 6.16 times higher likelihood of ADHD while the association was weaker and nonsignificant in males. Researchers did not know why the association was stronger in females.

Baker said mothers are often told to use acetaminophen, the primary agent in Tylenol, instead of ibuprofen, which is more likely to affect the fetal kidney or heart adversely.

“(Acetaminophen) is really the only option to control fever or pain during pregnancy,” he said.

There needs to be more research to figure out if some women can tolerate acetaminophen during pregnancy with no ill effects on the fetus while others cannot, he said.

“There is obviously more work that needs to be done in this area,” Baker explained. “And we need to continually update our guidance.”

The study was funded in part by the National Institutes of Health.

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