By Shimon Herman, Science and Technology Editor
On September 21, President Donald Trump proudly said, “We’re going to have one of the biggest announcement[s]…medically, I think, in the history of our country.” A day later President Donald Trump delivered a long-anticipated announcement from the Oval Office. The President suggested that Tylenol was an unsafe substance for pregnant women as it could lead to autism in their children. He claimed that there is a link between acetaminophen usage in pregnant women and the drastic increase in autistic children in recent years.
This announcement did not disappoint the nation’s expectations as it caused an explosion among the general public. It did not take long for people to begin questioning both President Trump’s remarks as well as the decades of research and studies seemingly pointing to Tylenol’s safety during pregnancy.
There is a disagreement regarding whether or not there is scientific evidence backing President Trump’s claim that Tylenol is potentially unsafe for pregnant women. There are various studies that clearly point to an association between neurodevelopmental issues such as autism and the prenatal use of Tylenol. Research such as the Nurses’ Health Study II in 2019 and the findings of a 2020 Boston Birth Cohort study have pointed to this association. The U.S Food and Drug Administration (FDA) recently stated that they have initiated a process for a label change for Tylenol, as these studies provide enough evidence to establish that Tylenol “may be associated with an increased risk of neurological conditions such as autism and ADHD in children.”
While these studies seem to show that there is potentially a risk involved in taking Tylenol while pregnant, many feel that the current consensus amongst doctors and scientists is that there is not enough proof to confidently state that there is a link between consuming Tylenol and autism. Many media outlets, including MSNBC and CBS, have cited the president’s claim as lacking concrete evidence. Former President Barack Obama angrily stated that President Trump’s announcement was inciting “violence against the truth.” Many have also voiced concern that this announcement has left thousands of pregnant women scared and confused regarding what they should consume.
Allison Aubrey, a Food and Health correspondent for NPR News, addressed the public’s concerns. “One reason research [regarding acetaminophen and autism] is difficult is that parents may not remember, or may misreport, how much of the drug they actually took during pregnancy,” she said. “That’s why researchers were particularly interested in one 2019 study that found that children with the highest levels of acetaminophen in their cord blood were roughly three times more likely to be diagnosed with autism compared with kids that had the lowest levels in their cord blood. However, the lead researcher was careful to note that the study did not show that the drug caused those disorders — just that there was an association.”
The fact that there is an association, which many have been quick to emphasize, does not mean there is establishable causation. A classic example is when ice cream sales go up, sunburn cases increase. However, buying ice cream does not cause sunburns, instead there is just an association between the two. In other words, it is possible that there is ultimately a different reason as to why autism cases are increasing that is not related to Tylenol or other acetaminophen products.
Another related conversation is the ongoing debate surrounding whether autism has truly increased over the past few decades or if this rise in cases is due to a more inclusive diagnostic criteria and more awareness of autism. The CDC reports that there has been a 300% increase in autism in the last 20 years, with one in 31 boys now having been diagnosed. President Trump seems to attribute this sharp increase to external influences in our day-to-day lives or environmental factors, like Tylenol. It is for this reason that President Trump has been trying so hard to pinpoint the culprit behind this drastic surge in autism cases. Others believe that the rise in reported autism cases is primarily due to increased awareness and more screening. Obama said recently, “A lot of what is being trumpeted as these massive increases [in autism cases] actually have to do with a broadening of the criteria across that spectrum.”
Overall, President Trump’s statement about Tylenol and autism needs to be viewed with clarity and nuance. While the medical community has not reached a consensus regarding the safety of Tylenol while pregnant, it is clear that the president wishes to emphasize that there is a lot that we do not fully understand regarding medications. No one is saying that Tylenol should be forbidden to take, rather the public is being informed of a possible danger associated with the drug. Whether or not a direct link between Tylenol and autism is ultimately proven, the statement made by the president reflects concern and caution for the health of future generations.
Photo Credit: Mike Mozart on Flickr