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During pregnancy, adequate glutathione levels are essential for proper brain development.[¹⁻⁵]† GLUTATHIONE’S CRITICAL ROLES[¹⁻⁵]† • Supports the developing brain’s healthy response to oxidative stress • Supports healthy methylation (controls gene expression) • Regulates homocysteine levels (elevated levels risk neural tube defects) • Enables proper epigenetic programming • Supports a healthy immune response within the brain and spinal chord and normal microglial activation THE CONNECTION TO NEURODEVELOPMENTAL DISORDERS Children with neurodevelopmental disorders consistently show low glutathione levels, elevated homocysteine, impaired methylation capacity, oxidative stress markers, and mitochondrial dysfunction.[⁶⁻⁸] Low maternal glutathione during pregnancy is associated with preeclampsia, HELLP syndrome, intrauterine growth restriction, fetal brain inflammation, and neurodevelopmental disorders.[²⁻³⁻⁶⁻⁹⁻¹⁰] WHAT THE RESEARCH SHOWS ABOUT TYLENOL AND PREGNANCY Several large observational studies identify associations between prenatal acetaminophen use and neurodevelopmental outcomes: • A 2021 meta-analysis of 73,881 mother-child pairs found children prenatally exposed to acetaminophen were 19% more likely to have symptoms associated with neurodevelopmental conditions and 21% more likely to have attention/focus symptoms.[¹¹] • A 2020 study measuring cord blood biomarkers found dose-response relationships with attention/focus disorders and neurological disorders risk.[¹²] • A 2018 meta-analysis of 132,738 mother-child pairs found associations that increased with longer exposure duration.[¹³] • A 2024 evaluation reviewed 46 studies, with higher-quality studies more likely to show positive associations.[¹⁴] HOW MUCH TYLENOL CAN I TAKE WHILE PREGNANT

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doi: 10.2337/dc19-0830 4 BjergLHulmanACarstensenBCharlesMJørgensenMEWitte.DR