Image Source: Pexels, Suzy Hazelwood
Author: Altay Shaw
During a press conference on the 22nd of September, US President Donald Trump asserted that acetaminophen, also referred to as paracetamol in the UK, was “associated with a very increased risk of autism“. He advised pregnant women to avoid using it and to only use it in extreme circumstances.
The claim has been attributed to a flawed 2020 study that was published in JAMA Psychiatry and showed a correlation between in utero exposure to paracetamol and the incidence of a diagnosis of autism and attention-deficit hyperactivity disorder (ADHD). The study was only observational in nature, where the researchers only observe the population, without manipulation or intervention, as opposed to the gold standard, which is randomised control trials where “investigators do intervene and look at the effects of the intervention on an outcome”.
An umbrella review published in the British Medical Journal, in response to the claims by the United States President, stated that the existing evidence “does not clearly link maternal paracetamol use during pregnancy with autism or ADHD in offspring.” With insufficient evidence to make such a claim, the researchers called for higher-quality studies to be performed into whether a link was found, controlling for familial and unmeasured confounders.
The study also highlighted errors from previous studies. One review, which was referenced in the umbrella review, looked at a 2013 paper that claimed there were substantially adverse developmental outcomes by the age of three when mothers took paracetamol. This study did not use formal diagnoses; rather, it relied on the developmental traits that were reported by mothers without being clear as to whether the mothers had received formal training to identify and make a clinical judgement. Furthermore, a comparison with similar studies revealed a shorter follow-up period.
The Medicines and Healthcare products Regulatory Agency (MHRA) released their safety round-up for September 2025, stating that pregnant women should continue to follow the existing advice provided by the NHS. The key advice for healthcare professionals stated that “there is no evidence that taking paracetamol during pregnancy causes autism in children” and that “untreated pain and fever can pose risks to the unborn baby, so it is important that patients continue to manage these symptoms with the recommended treatment.”
MHRA also advised against women trying another common form of analgesia, ibuprofen. As it belongs to the non-steroidal anti-inflammatory drugs class (NSAIDs), it is not recommended for pregnant women. Some reports say ibuprofen can reduce amniotic fluid, which can harm lung development. It might also cause an early closing of the ductus arteriosus, which is a connection between two big blood vessels from the heart, potentially leading to high blood pressure in the baby’s lungs.
For now, women should continue to follow the advice of their obstetricians and fellow members of their medical team during the course of the pregnancy. If there are concerns about developmental delay or familial risk, pregnant women should continue to reach out to healthcare professionals to make an informed decision.
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