Bogus Study: Association of Cord Plasma Biomarkers of In Utero Acetaminophen Exposure With Risk of Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder

It is no secret that when a pregnant person is experiencing pain or fever, acetaminophen, also known as Tylenol and Paracetamol, is most often recommended. It is the only painkiller considered safe for pregnant people to take for pain and fever without harming the fetus. At the same time, infant Tylenol is the first line of defense for pain for an infant. 

The Study Itself

There is a study that was recently published that says they prove that acetaminophen increases the risk of autism and ADHD. This does not make any sense because both conditions are genetic. Science really loves to blame the people are are pregnant with autistic and ADHD babies. 

The basis of this study was based on a rodent study that showed toxicity in neurons and inhibition of fetal testosterone which they say could critically distract brain development. acetaminophen is safe for rats in certain conditions, unlike other non human animals such as dogs and cats. 

Some human studies show acetaminophen can cross the placental barrier but is still considered a category 1 out of 4 for fetus safety, which category 1 is the most safe. 

In this study, 996 pregnant people in Boston, had the cord blood tested for biomarkers of acetaminophen when their singleton babies were born. This happened from October 1, 1998 to June 30, 2018. The umbilical cord blood was tested for three cord values for Tylenol (unchanged acetaminophen, acetaminophen glucuronide and 3[N0acetl-l-cystein-s-yl]- acetaminophen). 

After the babies were born, the parents reported if the children were diagnosed with autism, ADHD or both. They compared this to which baby had Tylenol present in thier umbilical cord blood. They use this to say that babies that are exposed to Tylenol in utero are more likely to be autistic or have ADHD. This is a correlation. Everyone must remember, correlation does not equal causation. 

Study Caused Warning Against Tylenol for Pregnant People

Due to this study, a group of 91 doctors and scientists issued a consensus statement warning possible links between the use of acetaminophen during pregnancy and developmental disabilities in the fetus.This statement was published by Ann Bauer of the University of Massachusetts in Lowell and colleagues in Nature Reviews Endocrinology. 

There was another paper published in Nature Reviews Endocrinology that reviewed medical literature going back 25 years in order to make a set of recommendations. This group of doctors and scientists are calling on clinicians and regulatory agencies, such as the FDA, to change thier guidelines based on this one study. 

This consensus is no consensus at all. It could be sending the wrong message to patients who need this medication. Acetaminphen is the only safe medication to treat pain and fever in pregnant patients. Experts have questioned the limitations of the evidence in this study. 

"I don't think we should actually be sending the message to pregnant individuals that 'well, there's no safe pain medicine you can take, so you should just have pain," said Katie Gray, MD, PhD, a maternal fetal medicine (perinatologist) specialist at Brigham and Women's Hospital in Boston. "I don't think that's appropriate care for patients."

The problem is, there is nothing in place for pain relief for the people who rely on it. "The authors are not recommending anything counter to what is already done by obstetrician - gynecologists when prescribing acetaminophen for a given clinical condition. Physicians should not change clinical practice until definitive prospective research is done and, most importantly, patients should not be frightened away from any benefits of acetaminophen. However, as always, any medication taken during pregnancy should used only as needed, in moderation, and after the pregnant patient has consulted with thier doctor," said Christopher Zahn, Vice President of practice actives for the American College of Obstetricians and Gynecologists."


Sources:

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2753512 

https://www.statnews.com/2021/09/23/new-research-cautions-about-possible-risks-of-acetaminophen-use-during-pregnancy/

https://www.medpagetoday.com/obgyn/pregnancy/94967



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