Podcast Summary: Chasing Life

Host: Dr. Sanjay Gupta (CNN Podcasts)
Episode: What the Science Says About Tylenol and Autism
Date: September 30, 2025

Overview

This episode dives into the recent FDA guidance regarding the use of acetaminophen (commonly known as Tylenol or paracetamol) during pregnancy and its possible links to autism and other neurodevelopmental conditions. Dr. Sanjay Gupta addresses listener questions, examines emerging research, and clarifies what current science does—and doesn’t—say about Tylenol’s safety for pregnant women and their babies.

Key Discussion Points and Insights

1. Tylenol (Acetaminophen) and Pregnancy: The Current Landscape

• Tylenol is the Most Commonly Recommended OTC Pain and Fever Medication for Pregnant Women:

  • Ibuprofen, aspirin, and other NSAIDs are known to carry direct risks to the fetus and are not recommended.
  • "Acetaminophen is considered the only safe over the counter option for pain or fever for a pregnant woman." (Dr. Gupta, 02:22)

• Recent FDA Statement:

  • The FDA has not advised pregnant women to stop taking Tylenol, but suggests minimizing use during pregnancy for routine, low-grade fevers.
  • There is no evidence of a causal relationship between acetaminophen and autism, only observation of potential associations. (03:09)

• Challenges in Studying These Associations:

  • Many studies rely on maternal recall years after pregnancy, making precise data difficult to obtain.
  • Measuring the presence of acetaminophen in cord blood offers another, though still imperfect, way to assess exposure.

• Key Message:

  • Associations don’t equal causation: “You can associate [Tylenol] to just about anything... that’s the key word association here, not cause and effect.” (Dr. Gupta, 04:35)

2. What the Research Shows

• Recent Swedish Study (04:46):

  • Followed over 2 million children born between 1995 and 2019.
  • Children of mothers who took acetaminophen were compared with siblings and non-exposed children—creating a "genetic control group."
  • Result: No increased risk of autism or neurodevelopmental disorders observed.
  • “In that study, they found no associated increased risk of autism or or other neurodevelopmental disorders in response to the use of acetaminophen.” (Dr. Gupta, 05:12)

• Acetaminophen Use Trends:

  • Tylenol use among pregnant women has decreased over the past decade, while autism rates have continued to increase.
  • “Tylenol use going down, autism rates going up. What does that mean?” (Dr. Gupta, 06:59)

• Norwegian Study on ADHD (07:27):

  • Use for 29+ days showed an association with doubled risk of ADHD.
  • Use for 1–7 days linked to a lowered risk of neurodevelopmental problems, possibly reflecting benefit of treating fevers.
  • "Treating fevers appropriately seems to have been protective, whereas taking perhaps too much Tylenol, taking it for more than a month may have been problematic." (Dr. Gupta, 08:02)

3. The Potential Risks of Fever During Pregnancy

• Why Controlling Fever is Essential:

  • High maternal fevers (e.g., over 103°F, especially in first trimester) present established risks—birth defects in brain, spine, heart; cleft lip/palate; miscarriage; early labor.
  • “A temperature that high can increase the risk of birth defects in the brain, the spine, and the spinal cord.” (Dr. Gupta, 09:36)
  • Fevers themselves have been linked to increased autism risk in some early studies.

• Safe Fever Management:

  • Acetaminophen remains the only recommended OTC antipyretic for pregnant women.
  • Aspirin/NSAIDs are contraindicated (except possibly low-dose aspirin for specific OB indications like preeclampsia, under physician advice).

4. Practical Recommendations for Pregnant Women

• Minimizing Fever Risk (11:04):

  • Wash hands frequently.
  • Stay current on vaccinations (influenza, COVID-19, etc.).
  • Ensure adequate sleep.
  • Avoid known sources of infection (food safety, avoiding sick contacts).
  • If a fever develops, contact a doctor.

• When to Take Tylenol:

  • Recommended if fever occurs, especially at high temperatures or early in pregnancy.
  • Use lowest effective dose for shortest necessary duration.

• Other Non-Drug Measures:

  • For low fevers, cooling methods (e.g., blankets) may be recommended.

Listener Questions & Memorable Moments

Q1: Should Guidance Focus on Women Who Use Tylenol Regularly?

(Devin from Vancouver) [06:35]

• Nuance Addressed:

  • Occasional, short-term Tylenol use to treat fever is likely safe and possibly beneficial compared to untreated fever.

  • Regular, prolonged use (29+ days) may be associated with higher ADHD (not autism) risk, but only as an association, not proven cause.

  • Memorable Quote:
    “Short term use was better for the baby than leaving a fever untreated. But when you get to a month or so of Tylenol use, that may potentially be problematic.” (Dr. Gupta, 08:03)

Q2: What are the Dangers of Fever in Pregnancy for Parent and Baby?

(Megan from New Mexico) [09:12]

• High fevers during critical periods increase risk for birth defects, miscarriage, congenital heart issues, and even possibly autism.
• "People who had a fever just before or during early pregnancy were more than twice as likely to have a child with a neural tube defect than those who didn’t have a fever." (Dr. Gupta, 10:23)

Q3: How Can Pregnant Women Lower Their Risk of Fever?

(Bill from Maine) [10:55]

• Focus on hygiene, vaccines, sleep, food safety, and avoiding illness.
• See a healthcare provider at first sign of significant fever.

Notable Quotes & Timestamps

• “There is no evidence of a causal relationship, meaning a cause and effect relationship between acetaminophen and autism.”
  — Dr. Sanjay Gupta, [03:09]

• “You can associate [Tylenol] to just about anything. ... That’s the key word—association here, not cause and effect.”
  — Dr. Sanjay Gupta, [04:35]

• “In that [Swedish] study, they found no associated increased risk of autism or other neurodevelopmental disorders in response to the use of acetaminophen.”
  — Dr. Sanjay Gupta, [05:12]

• “Short term use was better for the baby than leaving a fever untreated. But when you get to a month or so of Tylenol use, that may potentially be problematic.”
  — Dr. Sanjay Gupta, [08:03]

• “A temperature that high [103°F or higher] can increase the risk of birth defects in the brain, the spine, and the spinal cord.”
  — Dr. Sanjay Gupta, [09:36]

• "People who had a fever just before or during early pregnancy were more than twice as likely to have a child with a neural tube defect than those who didn’t have a fever."
  — Dr. Sanjay Gupta, [10:23]

Takeaway

The episode emphasizes that while research has observed associations between Tylenol use in pregnancy and neurodevelopmental outcomes, there is no evidence of causation. Untreated high fevers in pregnancy present real, proven risks to both mother and child. Current guidance—to minimize Tylenol to the lowest necessary dose for the shortest time—remains unchanged, and acetaminophen continues to be the best OTC option for fever in pregnancy. Listeners are reminded to always discuss medication use with their doctor and to practice good health habits during pregnancy.