A COMPREHENSIVE review of existing research has found no clear evidence linking maternal paracetamol (acetaminophen) use during pregnancy with autism or attention deficit/hyperactivity disorder (ADHD) in children.
Paracetamol in Pregnancy: Reviewing the Evidence
Researchers conducted an umbrella review, analysing nine systematic reviews encompassing 40 primary studies. These included randomised trials, cohort studies, case-control studies, and cross-sectional studies assessing maternal paracetamol intake and the subsequent diagnosis of autism or ADHD in offspring. The review examined study quality, potential biases, and the validity of reported associations.
Mixed Findings in Previous Research
While several reviews reported a possible association between prenatal paracetamol use and neurodevelopmental disorders, the majority of these studies were flagged for high risk of bias. Only two reviews were rated as having low confidence in their findings, with the remaining seven considered critically low. Researchers noted that overlapping primary studies and confounding factors, including maternal characteristics, underlying conditions, and familial influences, made it difficult to draw definitive conclusions.
Sibling-Controlled Analyses Show No Risk
Importantly, only one review included studies that used sibling-controlled analyses, which account for shared familial and environmental factors. In these analyses, any previously observed increases in autism or ADHD risk disappeared, indicating that paracetamol itself is unlikely to be the cause. For example, hazard ratios for autism and ADHD in sibling-controlled analyses were near 1, suggesting no significant increase in risk.
What This Means for Expectant Mothers
The findings highlight that the existing evidence does not support a clear causal link between maternal paracetamol use and autism or ADHD in children. Experts emphasise that pregnant individuals should continue to consult healthcare providers about safe medication use, but these results provide reassurance against overstated fears circulating in media and social discussions.
Takeaways
This umbrella review dispels misinformation suggesting a strong connection between prenatal paracetamol and childhood neurodevelopmental disorders. While further high-quality studies are always valuable, current evidence indicates that occasional, medically appropriate paracetamol use in pregnancy is unlikely to increase autism or ADHD risk in offspring.
Reference
Sheikh J et al. Maternal paracetamol (acetaminophen) use during pregnancy and risk of autism spectrum disorder and attention deficit/hyperactivity disorder in offspring: umbrella review of systematic reviews. BMJ. 2025;391:e088141.
