Acetaminophen use during pregnancy does not increase risk of autism or ADHD

A major review published in The Lancet Obstetrics, Gynecology & Women's Health found no link between taking acetaminophen as directed in pregnancy and autism, ADHD or intellectual disability; the conclusion was driven by higher-quality studies, including sibling-comparison analyses.

A large international review published in The Lancet Obstetrics, Gynecology & Women's Health examined whether acetaminophen (paracetamol) use during pregnancy is linked to autism, ADHD or intellectual disability. The researchers focused on higher-quality studies and designs thought better able to separate medication effects from other factors. The review followed public concern after earlier mixed study results and public statements questioning acetaminophen safety in pregnancy. Authors and several professional groups said the findings are consistent with guidance that acetaminophen remains the standard over‑the‑counter option when used as directed. Key findings: - The review concluded that the best-quality evidence does not support a causal link between taking acetaminophen during pregnancy and autism, ADHD, or intellectual disability. - Sibling-comparison analyses, which compare siblings with different in‑utero exposure, showed no association; this result was reported to hold even in studies with more than five years of follow-up. - The authors screened a large body of research and applied strict inclusion criteria; one report notes that 43 studies met the team’s quality standards for analysis. - Some officials, including an HHS spokesperson, criticized the review’s approach and said the broader evidence base was not fully considered, arguing the question remains unsettled. - Professional organizations cited in the coverage, and the maker of Tylenol, said the findings align with existing guidance that acetaminophen is the recommended option for pain or fever in pregnancy when used as directed. Summary: The review’s methods and focus on higher-quality and sibling-comparison studies led the authors to find no evidence that label-directed acetaminophen use in pregnancy causes autism, ADHD, or intellectual disability. The paper may help explain inconsistencies in earlier observational studies by addressing confounding factors related to why people take the drug. Some officials dispute the methods and maintain that the broader question is unresolved. Undetermined at this time.