Children could face a higher risk of developing attention-deficit/hyperactivity disorder (ADHD) if their mothers took acetaminophen — a common pain reliever and fever reducer — during pregnancy, researchers have found.
The study, which has sparked new discussions about the controversial topic, was recently published in the journal Nature Mental Health.
"Compared with no exposure, detection of acetaminophen in maternal blood during pregnancy was linked with three times the likelihood of the child developing ADHD," lead author Brennan Baker, a researcher at Seattle Children’s Research Institute, told Fox News Digital.
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To gather the data, researchers took blood samples from 307 Black women during their second trimester of pregnancy, then tested for markers of the fever-reducing medication.
They also sampled the mothers’ placentas after delivery to look for signs of increased inflammation in those exposed to acetaminophen.
(Previous studies have linked elevated inflammatory and immune responses during pregnancy with adverse neurodevelopment in children, Baker noted.)
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Researchers then followed up with the children at 8 to 10 years of age to determine how many had been diagnosed with ADHD, then determined whether prenatal exposure to acetaminophen was linked with a higher likelihood of the disorder.
The researchers also found DNA changes related to immune system pathways in the placentas that were exposed to acetaminophen, which was linked to a higher chance of children developing ADHD.
"This indicates that disruptions to the immune system could be a mechanism linking this exposure with child neurodevelopment," Baker said.
Dr. Ryan Sultan, an attending physician at NewYork-Presbyterian Hospital and director of the Mental Health Informatics Lab at Columbia University Irving Medical Center, said the study’s findings are both "important and concerning."
"What this study does well is push us closer to understanding modifiable prenatal risk factors," Sultan, who was not involved in the research, told Fox News Digital.
While the study adds to the growing consensus that acetaminophen is not risk-free, that doesn’t mean pregnant women can’t take Tylenol or other medications containing acetaminophen, experts told Fox News Digital.
"When possible, it should be used sparingly and only when medically necessary during pregnancy," Sultan advised.
There is a conflicting body of research on the use of acetaminophen during pregnancy and the risk of adverse neurodevelopment.
For example, a recent study of nearly 2.5 million Swedish children last year found no increased risk of autism, ADHD or intellectual disability among siblings who were exposed to the pain medication before birth.
A nationwide study in Taiwan, however, found that the use of acetaminophen in pregnancy increased the development of ADHD in offspring, regardless of whether the mothers had mental health disorders.
Many prior studies have relied on mothers’ self-reporting – which underestimates use, as many people take acetaminophen without knowing it, according to Baker.
Sultan cautioned that the study has some limitations.
Its sample size was small, the population was limited to Black mothers in the South, and exposure to acetaminophen was measured only at a single point in time, he noted.
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Another major limitation is the study design, as it cannot prove that acetaminophen use causes ADHD.
"We can never be 100% sure that an association is causal in an observational study like this, as there can always be unknown confounding factors," Baker told Fox News Digital.
"We tried to control for as many factors as possible, including family history of mental health conditions, maternal use of antibiotics, maternal use of other drugs used for pain/fever, socioeconomic status of the family, and prenatal tobacco and alcohol exposure," he added.
While the researchers may have identified a possible risk for ADHD, the mental health condition is a "complex, multifactorial deficit in executive functioning" that can manifest in a variety of ways, according to Dr. Lama Bazzi, a psychiatrist in private practice in New York City.
There are approximately six million pregnancies every year and 80% of women take at least one medication for a health problem diagnosed before or during pregnancy, according to the U.S. Food & Drug Administration.
The majority of women take acetaminophen at some point during pregnancy, with more use among those with anxiety and depression, according to past research.
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ADHD is one of the most common mental health conditions during childhood, according to the American Psychiatric Association.
The study was funded in part by the National Institutes of Health. Fox News Digital reached out to manufacturers of medications containing acetaminophen for comment.
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