- - Acetaminophen use during pregnancy not clearly linked to autism, ADHD, review finds

MARY KEKATOSNovember 10, 2025 at 4:52 AM

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Taking acetaminophen during pregnancy is not clearly linked to autism or attention-deficit/hyperactivity disorder (ADHD) in children, a new review finds.

The topic has been in the headlines since September when President Donald Trump warned that acetaminophen use in pregnancy was "associated with a very increased risk of autism" and the president advised pregnant women, "Don't take Tylenol."

At the time, federal officials cited an August 2025 meta-analysis from researchers at Mt. Sinai, Harvard T.H. Chan School of Public Heath, UCLA Fielding School of Public Health and UMass Lowell that found prenatal exposure to acetaminophen may be associated with an increase in rates of neurodevelopmental disorders, including autism and ADHD, in children.

However, the new analysis published Sunday in BMJ also examined a wide range of previously published reviews --and did not find such clear-cut evidence.

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As part of the new analysis, researchers from the U.K, Spain and Australia looked at nine systematic reviews that reported on the results of 40 studies examining maternal use of the over-the-counter pain medication while pregnant and child neurodevelopment.

Those nine reviews found a potential association between pregnant people's use of acetaminophen, also known as paracetamol, and "adverse neurodevelopmental outcomes."

The team found that seven of the nine reviews warned against drawing a causal link between use of the medication in pregnancy and autism, ADHD or both.

Jorge Martinez/Getty Images - PHOTO: Generic acetaminophen tablets.

Additionally, they found that many of the nine reviews had critical flaws such as not having a comprehensive search of the scientific literature, not listing excluded studies and the reason for their exclusion, inaccurate study designs and using non-standard tools for evaluating the risk of bias, according to the new review.

Dr. Shakila Thangaratinam, co-author of the new review and executive dean of the Institute of Life Course and Medical Sciences, at the University of Liverpool in the U.K., said the new analysis was partially in response to Trump's September announcement at a White House news conference that pregnant people's use of acetaminophen might raise the risk of autism in their children, contradicting many previously published studies that have found no causal link.

The president has since repeated that claim on social media and has suggested that young children, including babies, shouldn't be given the drug, known by the brand name Tylenol, without providing evidence to back up the statement.

Thangaratinam said the announcement in the U.S. "gained a huge amount of media attention, which means it became a key part of conversations in the health care space, paracetamol being the commonest medication that women take in pregnancy."

"We wanted to look at all of the existing evidence in the space, look at the quality and make sense of it and interpret it, so that it would help health care providers in discussion with women and their families," Thangaratinam continued.

She added that, as a consultant obstetrician, she is concerned that pregnant people might hold off using acetaminophen for high fever or severe pain, which can lead to serious complications for both the mother and the fetus.

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In addition, Thangaratinam said there are concerns that pregnant people might turn to other over-the-counter medications, such as ibuprofen, which is not considered safe to use in pregnancy.

Major medical groups, such as the American College of Obstetricians and Gynecologists (ACOG) strongly rejected the president's claim linking acetaminophen in pregnancy to autism, calling it "highly concerning," "irresponsible" and "not backed by the full body of scientific evidence.

For the new review, researchers found that many of the studies in the nine reviews examined did not adjust for other contributing factors such as genetics, maternal health and external environmental factors.

Only one of the nine reviews included studies that accounted for shared familial factors using a sibling control analysis, which looks at whether an apparent link is due to shared genetics and family environment. The studies in that review found that when adjusted for the sibling control, any association between pregnant people's use of Tylenol and autism or ADHD disappeared, according to Thangaratinam.

Nathan Howard/Reuters - PHOTO: Donald Trump attends a dinner with the leaders of the C5+1 Central Asian countries of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan, in Washington, D.C., November 6, 2025.

She said this means it's very likely the association that was initially observed was driven by shared familial, genetic and environmental factors, as well as unmeasured factors, rather than driven by acetaminophen use in pregnancy.

Additionally, many of the reviews looked at the same studies for their analyses.

The researchers rated these nine reviews as being "low" or "critically low" in the confidence of their findings meaning they may not or could not "be relied on to provide an accurate and comprehensive summary of the available studies."

Thangaratinam said the debate around acetaminophen use in pregnancy highlights the lack of drugs that have been developed and approved to treat pain, fever and other medical conditions in pregnant women.

"One of the reasons why paracetamol is one of the few drugs we can give [to pregnant women] is there is not much research in the safety of drugs in pregnancy, and a lot of the medications, when they're in the trial phase, pregnant women are actually excluded," she said. "Which means pregnant women [may] never actually have an opportunity to access the drugs that actually could help make them better. ... So there need to be a focus on drug discovery, as well as in science, in pregnancy."

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