Acetaminophen, also known by the brand name Tylenol, is a “safe and appropriate” first-line treatment for fever and pain during pregnancy when taken at recommended doses for the shortest duration necessary, the Society of Obstetricians and Gynecologists of Canada (SOGC) is reaffirming.
In fact, avoiding pain or fever relief during pregnancy could carry risks, it says.
The society, which represents thousands of obstetricians/gynecologists, family physicians, nurses, midwives and others across Canada, is underscoring a recommendation it first made in 2021. It is doing so “in light of reports raising questions about the safety of acetaminophen use in pregnancy”.
This week, in a press conference which is being widely condemned as irresponsible and based on anti-scientific fearmongering, U.S. President Donald Trump linked the use of acetaminophen during pregnancy with an increased risk of autism, something not supported by research.
Trump even offered direct medical advice, saying: “Don’t take Tylenol.”
Medical organizations and individual health professionals in the U.S. and Canada have taken to social media to combat the message coming from the White House, many saying they fear it could cause other problems and lead to confusion.
The SOGC emphasized that untreated fever in pregnancy carries “well-documented risks for both mother and baby, including fetal organ malformations, fetal cardiovascular complications and even autism spectrum disorder,” the society said in a statement.
“Access to effective pain management is considered a human right, which women should not be denied just because they are pregnant.”
Despite some claims suggesting a causal link between prenatal exposure to acetaminophen and certain neurodevelopmental disorders, the SOGC reasserted “the evidence supporting these claims is weak and has been consistently refuted by scientific and regulatory bodies. Reputable international medical organizations have likewise firmly stated that current clinical practice regarding acetaminophen use during pregnancy should not change.”
In the U.S., the Food and Drug Administration says it is changing labels on products containing acetaminophen “to make parents and doctors aware of a considerable body of evidence about potential risks associated with acetaminophen.”
In a statement, the FDA noted that evidence in recent years has suggested a correlation between acetaminophen use during pregnancy and subsequent diagnosis of conditions like autism and ADHD. Some studies have described that the risk may be most pronounced when acetaminophen is taken chronically throughout pregnancy.
It also noted that while an association has been described in studies “a causal relationship has not been established and there are contrary studies in the scientific literature.” It is also noted that acetaminophen is the only over-the-counter drug approved for use to treat fevers during pregnancy and high fevers in pregnant women can pose a risk to their children. Aspirin and ibuprofen also have “well-documented adverse impacts on the fetus.”
It concluded that the precautionary principle “may lead many to avoid using acetaminophen during pregnancy, especially since most low-grade fevers don’t require treatment.
“It remains reasonable, however, for pregnant women to use acetaminophen in certain scenarios.”
The SOGC, meanwhile, suggests people discuss questions or concerns about medications in pregnancy with their health-care provider.
“In an age of growing misinformation and disinformation, the SOGC strongly urges all Canadians to ensure decisions about their health care are guided by evidence-based science and clinical expertise.”
