Overview

• The systematic review applied the Navigation Guide methodology to 46 studies with more than 100,000 participants across multiple countries, weighting each study by quality and bias assessment.
• Higher-quality research in the review more often identified associations between prenatal acetaminophen exposure and increased risks of autism spectrum disorder and ADHD in offspring.
• Authors outline biological plausibility with acetaminophen crossing the placenta and potentially causing oxidative stress, hormonal disruption, and epigenetic changes in fetal brain development.
• While the review strengthens evidence for an association, it does not establish causation and calls for cautious, time-limited use under medical supervision and revised clinical guidelines.
• Given acetaminophen’s widespread use in pregnancy, even a modest increase in neurodevelopmental risk could have significant public health implications and underscores the need for further rigorous research and safer alternatives.