Paracetamol Use During Pregnancy Not linked to Increased Autism or ADHD Risk, Major Review Finds
A complete analysis of existing research has found no convincing evidence linking paracetamol use during pregnancy to an increased risk of autism or ADHD in children. The findings, published monday in the British Medical Journal, aim to provide clarity for expectant mothers and healthcare providers following unsubstantiated claims made by the previous US administration.
The publication of this research was expedited to counter misinformation circulating after former President Donald Trump publicly urged pregnant women to avoid paracetamol – also known as acetaminophen or Tylenol – in September, alleging a connection to rising rates of neurodevelopmental conditions. He even implored women to “fight like hell” not to take the common pain reliever.
While diagnoses of autism have increased in recent decades, scientists largely attribute this trend to greater awareness, improved diagnostic tools, and evolving criteria used to define the condition. The new “umbrella review” analyzed nine previously published systematic reviews, encompassing 40 observational studies, to assess the potential link between paracetamol exposure in utero and neurodevelopmental outcomes.
Researchers concluded that the quality of the existing evidence was consistently “low to critically low.” Any perceived association between the painkiller and autism was likely attributable to family genetics and othre confounding factors.
“Women should know that the existing evidence does not really support a link between paracetamol and autism and ADHD,” stated Prof. Shakila Thangaratinam, a consultant obstetrician and senior author of the review at the University of Liverpool. “If pregnant women need to take paracetamol for fever or pain then we would say please do, notably because high fever in pregnancy could be hazardous to the unborn baby.” She emphasized that alternative painkillers like ibuprofen are not recommended during pregnancy.
The review highlighted that all studies reported some possible association between a mother’s paracetamol use and neurodevelopmental conditions in her children. However, seven of the nine reviews cautioned against drawing firm conclusions due to the inability to adequately control for other influential variables.
Only one review incorporated data from two studies that properly accounted for genetic predispositions and pre-existing maternal health conditions. This research, published last year, examined data from 2.4 million Swedish children and initially found slightly higher rates of autism, ADHD, and intellectual disability among those whose mothers had used paracetamol during pregnancy. However, when researchers compared siblings – some exposed to the drug and others not – the effect vanished, suggesting that genetics, underlying health, or shared environmental factors were the primary drivers.
“If there’s a family history of autism and ADHD, either in the parents or the siblings, then it is indeed likely that that is the reason a child is diagnosed rather than something the mother took in pregnancy,” explained Thangaratinam.
Beyond the scientific findings, the researchers hope the review will alleviate anxiety and guilt among women who may have taken paracetamol during pregnancy. “They might have a child that is autistic with ADHD and we really don’t want them to think it’s as of something they did in pregnancy. That’s a terrible feeling for a mother to have,” Thangaratinam said. “There isn’t anything in the current evidence that suggests mothers taking paracetamol is actually causing autism and ADHD.”
Prof.Dimitrios Siassakos,an honorary consultant in obstetrics at University College London,affirmed that the review reinforces the consensus among medical experts worldwide following Trump’s comments. “Paracetamol is the safest medication to use in pregnancy, and has been used by the majority of pregnant women globally for several decades without any impact on autism and ADHD,” Siassakos said. “It is also the safest to use if there is maternal fever, whereas untreated high temperature is a risk factor for poor pregnancy outcomes, including adverse foetal outcomes.High temperature and inflammation have a negative impact on foetal and neonatal brains and untreated inflammation can cross the placenta.”
