BUFFALO, N.Y. (WKBW) — President Donald Trump announced the U.S. Food and Drug Administration will notify physicians that acetaminophen use during pregnancy "can be associated with a very increased risk of autism."
The recommendation has sparked concern and confusion among expectant mothers and healthcare providers. To address these concerns, I asked Dr. Stephen Turkovich, president of Oishei Children's Hospital, about the potential risks and what pregnant women should know.
Dr. Turkovich explained that the developing fetal brain is particularly vulnerable to acetaminophen's effects.
"Really, it's the fetal brain that we're talking about and one of the reasons why I think there's enough caution here is in animal studies, we have seen the effects of acetaminophen or Tylenol on the growing fetus," Turkovich said.
The medication can cross the placental barrier, with fetal blood levels reaching similar concentrations to the mother's within about an hour of ingestion.
"We know that Tylenol can cross the placental border and what happens then is the blood levels in the fetus can reach about the same blood levels in the mom about an hour after she takes it. So, we know that it's in the baby," Turkovich said.
The doctor outlined several ways acetaminophen could potentially affect fetal brain development. As the medication is metabolized in the brain, it can create toxic compounds that may be harmful to developing neural tissue.
Additionally, acetaminophen can impact the endocrine system and hormone production, which plays a crucial role in brain development.
"Tylenol can impact the endocrine system or your hormones, and hormones also, when they activate, can help develop the brain. So, if you're disrupting that, you can disrupt the normal brain development patterns," Turkovich said.
The medication may also affect gene expression during fetal development.
"Tylenol can impact the way that genes are expressed. So, as you are growing a baby inside, all those genes are giving you instructions on how to build your body. And if Tylenol can impact the way that genes are expressed, it can impact the instructions that your body is using to build your brain," Turkovich said.
While animal studies have shown these effects, establishing a definitive causal relationship in humans remains challenging due to the widespread use of acetaminophen and numerous other variables that could influence outcomes.
"I think one of the challenges is Tylenol is so widely used and to try to say that that one thing is tied to something else, when there's all these other variables, whether they be genetic, other diseases, comorbidities in a mom, socioeconomic factors, all those sort of things and try to tease out and say, 'Tylenol use is tied to this', It's very, very difficult," Turkovich said.
Multiple studies are currently underway to better understand the potential connection, though no specific timeline has been announced for conclusive results.
For pregnant women concerned about pain management, Turkovich recommended consulting with their obstetrician-gynecologist (OBGYN) before making any changes to their medication routine.
"I would say talk to your OBGYN. If you have pain that's not being controlled with non-medical treatments, non-medication treatments, or if you have a fever and infection, definitely talk to your OBGYN," Turkovich said.
He emphasized that while non-pharmacological treatments should be tried first, untreated fever and pain can also pose risks to the developing fetus.
"If it's getting worse, you don't want to have ongoing fever and you don't want to have ongoing pain because that in and of itself can cause harm to the fetus," Turkovich said.
The complete 10-minute interview with Dr. Turkovich is available below:
