Trump officials warn pregnant women about Tylenol. Western Pennsylvania doctors offer second opinion

Dr. Devon Ramaeker, who treats women with some of the highest-risk pregnancies in western Pennsylvania, has advice for those who are concerned about a possible link between acetaminophen and autism.

President Donald Trump announced in a Sept. 22 news conference that the Food and Drug Administration will notify physicians that the use of acetaminophen is associated with an increased risk of autism.

“I encourage women to reach out to their medical providers and I encourage them to lean on medical knowledge that these providers have,” said Ramaeker, an obstetrician and division director of maternal-fetal medicine at AHN Women’s Institute in Pittsburgh.

Acetaminophen, often sold under the brand name Tylenol, has long been considered the safest option for managing headaches, fever and other pain during pregnancy. But Trump urged pregnant women to “fight like hell not to take it.”

Trump’s announcement comes after dozens of studies have shown no definitive evidence between a pregnant person’s frequent use of acetaminophen, and autism or attention deficit hyperactivity disorder in their child.

Dr. Steven Fleischman, president of the American College of Obstetricians and Gynecologists, said the studies that showed a causal relationship had “methodological limitations — for example, lack of a control for confounding factors or use of unreliable self-reported data.”

There are many studies, however, that link fevers in the early stages of pregnancy to increased risk to both mother and baby, Ramaeker said.

“Untreated fever in the first trimester of pregnancy increases the risk of birth defects, including spina bifida,” Ramaeker said.

Ibuprofen, aspirin use carry risk for pregnant women and babies

Other over-the-counter pain relievers carry risks for pregnant women and their babies.

Regular doses of ibuprofen or aspirin taken during a women’s second or third trimester can impact the baby’s kidney function and the mother’s levels of amniotic fluid, Ramaeker said.

Low doses of aspirin, however, can help prevent preeclampsia, dangerously high blood pressure.

“Dosing is very important,” Ramaeker said. “We recommend the low-dose aspirin to prevent preeclampsia but higher doses can impact the pregnancy.”

Ramaeker: No single cause for autism, ADHD

Despite what people may have heard in recent days, the actual causes of autism and ADHD can’t be attributed to a single factor, such as taking acetaminophen during pregnancy, Ramaeker said.

“The cause of autism is likely multiple pathways,” Ramaeker said. “It’s not as simple as taking one type of pain reliever.”

If you have any questions about the safety of pain relievers taken during pregnancy, consult your doctor, Dr. Donald Yealy, UPMC’s chief medical officer, said in a statement.

“It is natural to seek explanations and explore potential triggers for medical conditions, especially during pregnancy,” Yealy said. “We encourage anyone who is pregnant to discuss all medications and healthcare questions with their trusted health-care provider.”