Overview
- Researchers synthesized 43 cohort studies, with 17 eligible for meta-analysis, giving primary weight to sibling-comparison designs that better control for shared familial factors.
- Across the most robust analyses, prenatal acetaminophen exposure showed no association with autism, ADHD, or intellectual disability, while small elevations in conventional studies diminished under stronger methods.
- The pooled evidence spanned large populations, including about 262,852 children assessed for autism, 335,255 for ADHD, and 406,681 for intellectual disability.
- Major professional bodies and regulators, including ACOG, RCOG, FIGO, SMFM, the EMA, the MHRA, and Health Canada, maintain recommendations to use paracetamol as directed in pregnancy due to known risks of untreated fever or severe pain.
- Authors highlight limitations such as heterogeneous exposure and outcome measures and limited dose or timing data, calling for biomarker-based research as the findings counter recent U.S. warnings.