Sept. 30 (UPI) — Healthcare professionals maintain that acetaminophen is safe to use at recommended doses during pregnancy, despite last week’s announcement by the Trump administration.
President Donald Trump and Secretary of Health and Human Services Robert F. Kennedy Jr. claimed during a press conference there is a connection between the use of acetaminophen, the active ingredient in Tylenol, and autism but leading organizations representing obstetricians, gynecologists and pediatricians have rejected the claim.
Kennedy advised that healthcare providers prescribe the lowest doses of acetaminophen possible to pregnant mothers and only when treatment is required.
The American Academy of Pediatrics and American College of Obstetricians and Gynecologists cited a lack of evidence showing a causal relationship between acetaminophen use and autism.
“Regarding autism, we know it is complex, highly variable and increasingly linked to genetics,” the American Academy of Pediatrics said in a statement. “There is no single, root cause of autism, and there is no single medication that will give every autistic child or adult what they need.”
Dr. Scott Sullivan, American College of Obstetricians and Genecologists District 4 chair and spokesperson, told UPI the announcement by the Trump administration has created fear and confusion among patients already.
“We suspected that it would cause a lot of fear and confusion among our patients and in fact in my own practice I’ve seen that and in discussions with other OB-GYNs around the region and the country it’s the same thing,” Sullivan said.
“It was unnecessary to cause this much alarm because there was no new evidence, no new research and the body of evidence which has been evaluated not only by me but experts all over the country and at ACOG have found no reputable links with acetaminophen used during pregnancy and either autism or any neurological disorder.”
In practice, Sullivan does not expect medical professionals will change their approach to pain and fever management during pregnancy or beyond.
“One of the things we keep saying over and over is discuss this with your physician,” he said. “If you have questions, bring those to them and seek reputable sources of information.”
Alternatives to acetaminophen, such as non-steroidal anti-inflammatory drugs like aspirin and naproxen, have a higher risk profile, Sullivan said.
While Trump advised that pregnant mothers “tough it out” rather than taking acetaminophen, Sullivan said that advice can be dangerous to follow.
“In terms of taking a medication for a fever or pain, which is the most common reason people take acetaminophen, we believe Tylenol is the safest,” Sullivan said. “Fever certainly has risks. Untreated pain, we know it’s just cruel to tell people to suffer when there’s a treatment. Additionally, there’s good evidence that if you don’t treat pain in a timely manner, that has risks too. You can get longer-term pain. You can have psychological effects like depression and anxiety and those things have consequences too.”
During the announcement on Sept. 22, Kennedy cited research by the UC Davis Mind Institute at the University of California, saying the increase in autism diagnoses is not the result of advancements in diagnostic testing and changing criteria.
“That’s one of the canards that has been promoted by the industry for many years that it’s changed diagnostic criteria, better recognition,” Kennedy said. “But there’s been study after study done of that, that completely debunks that. One of them by the Mind Institute at UC Davis, University of California.”
The UC Davis Health public affairs department told UPI in a statement that it does not know what study Kennedy is referring to but it may be a 16-year-old study on increasing autism diagnoses. It clarified the findings of this study, saying it found many reasons for more autism diagnoses based on the best information available at the time, but the diagnostic criteria has changed since the study was published in January 2009.
“Autism has no single known cause,” the statement from UC Davis Health said. “The latest research shows both genetics and environment play a role. Some studies seem like they show a link between Tylenol (acetaminophen) during pregnancy and autism, but there are other reasons that link might exist. These include similarities among family members and the reasons people took acetaminophen while pregnant.”
UC Davis Health noted that the use of acetaminophen during pregnancy has remained the same or gone down while the number of autism diagnoses has continued to rise.
“If there was a link between these, we would expect both to go up or both to go down together,” the statement said.
During the Trump administration’s announcement of its believed connection between acetaminophen and autism, Kennedy announced that he has advised the National Institutes of Health, Food and Drug Administration and Centers for Medicare and Medicaid Services to guide doctors in treating children with autism with the drug leucovorin.
Leucovorin, or folinic acid, is a B vitamin. It is commonly used to treat the side effects of chemotherapy.
Kennedy said it can help treat the symptoms of autism in children, noting that folate abnormalities are potentially linked to autism.
The FDA has begun the process of approving leucovorin calcium tablets for patients with cerebral folate deficiency.
“We have witnessed a tragic four-fold increase in autism over two decades,” Marty Makary, FDA commissioner, said in a statement. “Children are suffering and deserve access to potential treatments that have shown promise. We are using gold standard science and common sense to deliver for the American people.”
The American Academy of Pediatrics says “small studies” have shown a potential link between leucovorin and improving communication skills in some autistic children but more research is needed.