Unproven Trump autism claim affected care: Research

President Trump’s urging of pregnant women to avoid taking Tylenol last year on the unfounded claim that it could be linked to autism in children resulted in a notable drop in orders for the common over-the-counter medication among pregnancy-related emergency department visits, according to an analysis published this week.

The study, published in The Lancet medical journal, looked at hospital data of emergency department visits in the months before and after Trump warned in September against taking acetaminophen while pregnant.

It found that orders for acetaminophen among pregnant emergency department patients aged between 15 and 44 fell by 10 percent while no significant change in acetaminophen use was found among nonpregnant female emergency department patients in the same age range.

“Taking Tylenol is not good,” Trump said from the Oval Office. “Fight like hell not to take it.”

To support his claims, Trump and the health leaders in his administration cited a National Institutes of Health-funded review by Mount Sinai and Harvard researchers, which analyzed previous studies and found an “association” of acetaminophen use during pregnancy and neurodevelopmental disorders, though it did not establish a causal link.

During the same briefing in which Trump warned against taking acetaminophen, Food and Drug Administration (FDA) Commissioner Marty Makary said his agency would be promoting leucovorin, a form of the B vitamin folic acid, as a way of reducing autism symptoms.

A change in leucovorin uptake was also observed by the study, with outpatient leucovorin prescriptions for children between 5 and 17 years of age jumping by 71 percent in the study period.

“Although causal claims cannot be made, the observed associations are consistent with influence of new FDA recommendations on clinical decisions,” the study stated. “It is unknown whether the results reported reflect changes in patient demand or clinician decision making; nonetheless, they show the apparent power that public authority figures have to drive sudden changes in health-care practices.”

The authors noted that the recommendations coming from the White House were based on “low-quality evidence,” yet was still enough to increase interest despite there being “no new data.”

The study published this week was authored by Jeremy Samuel Faust, assistant professor at Harvard Medical School, and Michael L. Barnett, Sorensen Family Provost’s professor of health services, policy, and practice at Brown University School of Public Health.