Image: The New York Times
A new federal health report could stir major debate on autism. The U.S. Department of Health and Human Services (HHS) is preparing to release findings that may connect autism risk to a widely used pain reliever and nutritional deficiencies during pregnancy, according to the Wall Street Journal.
The upcoming report is expected to highlight Tylenol (acetaminophen), when taken during pregnancy, and low folate levels, as possible contributors to autism development in children. It will also discuss whether folinic acid—a specialized form of folate—could ease symptoms of autism in some patients.
Tylenol Use During Pregnancy Under Spotlight
Tylenol, sold under the brand name but also available in generic form as acetaminophen, is one of the most common pain relievers in the United States. Many pregnant women use it because it is considered safer than other pain medications.
However, the report suggests that prenatal exposure to Tylenol, combined with low folate levels, might increase the risk of autism. Folate is vital for brain and spinal cord development during pregnancy.
Drugmaker Kenvue, which markets Tylenol, strongly rejected the suggestion. “We believe there is no causal link between acetaminophen use during pregnancy and autism,” the company said.
Experts Urge Caution Before Drawing Conclusions
Medical experts stress that the science remains unsettled.
Dr. Christopher Zahn, a senior leader at the American College of Obstetricians and Gynecologists, said no clear proof exists linking acetaminophen use during pregnancy to autism.
“Neurodevelopmental disorders are multifactorial,” he explained. “Pregnant patients should not be frightened away from acetaminophen, which remains one of the safest pain relief options available.”
The U.S. Food and Drug Administration and the Society for Maternal-Fetal Medicine have previously reviewed studies on this topic. Both concluded that evidence is inconclusive and riddled with methodological flaws.
Folate’s Role in Pregnancy
Folate supplements are already standard recommendations for women during pregnancy. They help prevent serious neural tube defects such as spina bifida.
Now, the report points to folinic acid—an advanced form of folate, also known as leucovorin—as a possible way to reduce autism-related symptoms. Researchers caution, however, that this treatment is not a cure and requires further study.
Autism Rates Continue to Rise
Autism diagnoses in the U.S. are climbing. In 2022, about 1 in 31 children was identified with autism by age eight, up from 1 in 36 in 2020, according to the Centers for Disease Control and Prevention (CDC).
Experts say two factors explain the increase:
Broader diagnostic definitions since 2013.
Improved awareness and screening, particularly in young children.
As a result, more families are seeking evaluations and support than ever before.
Conflicting Studies Add to the Debate
Research on acetaminophen and autism has delivered mixed results.
A 2024 study in JAMA looked at over two million children in Sweden. It found no increased risk of autism or ADHD among children whose mothers used acetaminophen during pregnancy.
A meta-analysis in BMC Environmental Health** reviewed 46 studies and concluded there was “strong evidence” of an association between prenatal acetaminophen use and autism. Still, the authors warned that an association does not prove causation.
Experts recommend cautious use of acetaminophen during pregnancy: the **lowest effective dose for the shortest possible duration**, under medical guidance.
Growing Concerns, But No Clear “Smoking Gun”
HHS Secretary **Robert F. Kennedy Jr.**, who has previously voiced controversial views on autism causes, promised new answers this month. Critics warn against pinning autism on one or two “smoking gun” factors.
Dr. Peter Hotez, a pediatrician and autism researcher, emphasized that both genetics and environmental triggers play roles. “It would be reckless to focus only on acetaminophen and folate deficiency,” he said.
The Autism Science Foundation also urged restraint, calling current evidence “limited, conflicting, and inconsistent.”
What Families Should Know
The pending HHS report may spark new conversations about pregnancy health and autism risk. But for now, doctors and health agencies continue to recommend folate supplements and careful, guided use of pain relievers.
Autism remains a complex condition shaped by genetics, environment, and biology. As scientists continue searching for answers, health experts advise pregnant women to consult their doctors rather than act on speculation.
