More on acetaminophen and autism

From a pediatrician colleague:

“. . . the study which is being used by certain parties to prove that “Taking Tylenol during pregnancy causes autism” does not actually say that. It says that there seems to be a slight increase in rates of autism among children whose mothers took Tylenol during pregnancy, BUT the lead author goes to great pains to say that the study did not control for other variables and factors so this does not PROVE anything. For example, the reason why the pregnant person took Tylenol might be because they were having bad headaches or fevers or other conditions that might mitigate toward neurological problems in the infant, but the authors of this paper emphatically say that they do NOT believe that their findings show that Tylenol during pregnancy causes autism.

“What makes this wild, unfounded, inflammatory statement especially dangerous is that fever, in and of itself, in pregnancy can be damaging to the fetus. It could be a sign of infection. The fever itself might cause long-term problems for the fetus or even miscarriage. Bottom line: Fever in pregnancy has to be taken seriously and if it  is not treated, it could have dire consequences for the unborn child.

“Beyond that, if people are discouraged from taking Tylenol during pregnancy, they may decide to take other fever medicines like ibuprofen. Unfortunately, taking NSAIDs like ibuprofen during the last half of pregnancy has been clearly demonstrated to cause problems. If someone listens to these officials while they’re pregnant and they decide to take Advil instead of Tylenol, that could cause grave harm for both mother and baby.”

For now, I’d conclude that (a) the burden of proof for the claim that gestational acetaminophen causes autism rests with those making the claim, and (b) that burden has not been met. There are other reasons to avoid acetaminophen (it is hepatotoxic), but autism isn’t among them.