Using paracetamol during pregnancy may increase child’s autism and ADHD risk, study finds

Prenatal exposure to paracetamol may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD), in children, new research suggests.

The study is the first to apply the rigorous Navigation Guide methodology to systematically evaluate the rigor and quality of the scientific literature.

Paracetamol is the most commonly used over-the-counter pain and fever medication during pregnancy and is used by more than half of pregnant women worldwide.

Until now, Paracetamol has been considered the safest option for managing headache, fever, and other pain.

Analysis by the Mount Sinai-led team of 46 studies incorporating data from more than 100,000 participants across multiple countries challenges this perception and underscores the need for both caution and further study.

The Navigation Guide Systematic Review methodology is a gold-standard framework for synthesizing and evaluating environmental health data.

This approach allows researchers to assess and rate each study’s risk of bias, such as selective reporting of the outcomes or incomplete data, as well as the strength of the evidence and the quality of the studies individually and collectively.

Diddier Prada, MD, PhD is Assistant Professor of Population Health Science and Policy, and Environmental Medicine and Climate Science, at the Icahn School of Medicine at Mount Sinai.

The researcher said: “Our findings show that higher-quality studies are more likely to show a link between prenatal acetaminophen [Paracetamol] exposure and increased risks of autism and ADHD.

“Given the widespread use of this medication, even a small increase in risk could have major public health implications.”

The paper also explores biological mechanisms that could explain the association between Paracetamol use and these disorders.

Paracetamol is known to cross the placental barrier and may trigger oxidative stress, disrupt hormones, and cause epigenetic changes that interfere with fetal brain development.

While the study does not show that Paracetamol directly causes neurodevelopmental disorders, the research team’s findings strengthen the evidence for a connection and raise concerns about current clinical practices.

The researchers call for cautious, time-limited use of Paracetamol during pregnancy under medical supervision; updated clinical guidelines to better balance the benefits and risks; and further research to confirm these findings and identify safer alternatives for managing pain and fever in expectant mothers.

Dr. Prada said: “Pregnant women should not stop taking medication without consulting their doctors.

“Untreated pain or fever can also harm the baby.

“Our study highlights the importance of discussing the safest approach with health care providers and considering non-drug options whenever possible.”