Does paracetamol/acetaminophen use in pregnancy increase the risk of neurodevelopmental disorders in children?

Various studies over the years have linked prenatal use of the pain reliever paracetamol (acetaminophen) with neurodevelopmental disorders such as autism and attention-deficit/hyperactivity disorder (ADHD) in children, but many of the studies were small, poorly designed, or found only weak associations. A recent “umbrella” review in Developmental Medicine & Child Neurology reveals that the available scientific evidence does not support a causal relationship between paracetamol and neurodevelopmental disorders.

For the review, 7 meta-analyses were included, encompassing more than 3 million participants. Unrestricted assessments showed small positive associations between prenatal paracetamol exposure and both autism and ADHD, but after restricting assessments to higher-quality meta-analyses and studies, effect estimates were substantially attenuated and approached null. No robust epidemiological evidence supported a causal association.

“A widely debated question deserves more than headlines—it deserves robust evidence. Our findings show that the apparent association between prenatal paracetamol exposure and autism or ADHD weakens as methodological quality improves, challenging the interpretation of a causal link and supporting evidence-based decisions during pregnancy,” said first author Hoda Tayebi Hillali, DDS, MSc, of the University of Santiago de Compostela, in Spain.

URL upon publication: https://onlinelibrary.wiley.com/doi/10.1111/dmcn.70512