The controversy surrounding the use of Tylenol during pregnancy has been brought to the forefront once again, as a Harvard dean and preeminent epidemiologist, Andrea Baccarelli, provided expert testimony in a lawsuit against the drug’s maker. Baccarelli’s testimony, which claimed a link between prenatal exposure to acetaminophen and neurodevelopmental disorders such as autism and ADHD, was called “unreliable” by a federal judge.

Baccarelli, who was paid roughly $150,000 for his work on the case, submitted written testimony based on his review of the scientific literature. However, U.S. District Judge Denise Cote criticized Baccarelli for downplaying studies that contradicted his causation thesis and only emphasizing those that aligned with it. The judge ultimately ruled to exclude Baccarelli’s testimony from the case, along with that of four other paid expert witnesses.

Despite the judge’s decision, Baccarelli’s stance on the issue remains unclear. In a statement released prior to the Trump administration’s recommendation to limit acetaminophen use during pregnancy, Baccarelli expressed the need for further research to confirm the association and determine causality. However, he also urged caution about acetaminophen use during pregnancy, especially heavy or prolonged use.

Baccarelli’s most recent paper, which reviewed 46 previously published human studies, found an association between acetaminophen use during pregnancy and neurodevelopmental disorders. While the paper suggests that pregnant women should limit acetaminophen consumption to protect their offspring’s neurodevelopment, other researchers have questioned the methodology and conclusions of the study.

Critics argue that Baccarelli’s inclusion of both unadjusted and adjusted findings in the review strengthened the association with autism but may have biased the results. Additionally, the subjective assessment of each paper’s quality of evidence has raised concerns among researchers unaffiliated with the study.

Despite the ongoing debate, researchers emphasize the importance of balancing the potential risks of acetaminophen use during pregnancy with the benefits of treating pain and fevers. While some studies have found no effect between acetaminophen and autism, the evidence is still inconclusive. As government officials weigh in on the issue, it is crucial to consider the potential impact on public health.

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