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Major Reviews Find No Causal Link Between Prenatal Acetaminophen and Autism or ADHD

Stronger analyses that compare siblings suggest familial confounding drives earlier associations.

Overview

  • An umbrella review in The BMJ assessed nine prior reviews encompassing 40 studies and found no clear evidence that acetaminophen use in pregnancy causes autism or ADHD.
  • A separate review in the Journal of the American Academy of Child & Adolescent Psychiatry evaluated 16 studies covering nearly 3 million children and reached the same conclusion.
  • In sibling-controlled studies from Sweden and Norway, initial risk signals disappeared, pointing to shared genetic or environmental factors rather than the medication.
  • The BMJ authors rated many earlier reviews low to critically low quality on AMSTAR 2 due to design weaknesses, bias, and inadequate control of confounders.
  • Despite recent government moves to caution against Tylenol use, medical groups continue to recommend acetaminophen when clinically needed, warn that untreated fever can harm pregnancies, and urge better-designed research.