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Largest Review Finds No Link Between Prenatal Acetaminophen and Autism or ADHD

Guidance remains unchanged despite continued skepticism from some U.S. officials.

Overview

  • A Lancet systematic review of 43 studies, prioritizing sibling-comparison and low-bias designs, found no clinically important association between prenatal acetaminophen use and autism, ADHD, or intellectual disability.
  • The UK’s MHRA and major medical bodies reaffirm paracetamol as the first-line option for treating pain or fever in pregnancy when used as directed.
  • Some U.S. officials continue to question the findings, citing concerns about study design and interpretation, even as many experts describe the review as rigorous and reassuring.
  • Sibling-comparison analyses, including large Swedish and Japanese cohorts, showed that associations seen in conventional studies weakened or disappeared after accounting for family and genetic factors.
  • Authors note remaining gaps in the literature, including inconsistent exposure measures and limited data on dosage and timing, though overall evidence does not support increased neurodevelopmental risk.