Overview

• The Navigation Guide review analyzed 46 observational studies from multiple countries to evaluate the rigor and bias of existing research on prenatal acetaminophen use.
• Studies rated as higher quality were more likely to report associations between maternal acetaminophen exposure and greater risks of autism spectrum disorder or ADHD in children.
• Authors emphasize that the evidence remains observational and does not establish causation, citing limitations such as residual confounding and the absence of a quantitative meta-analysis.
• The paper explores biological mechanisms—including placental transfer, oxidative stress, hormonal disruption, and epigenetic changes—that could plausibly link acetaminophen to altered fetal brain development.
• Researchers urge updated clinical guidelines calling for time-limited use under medical supervision, further studies on dose, timing and sex-specific effects, and development of safer pain-relief alternatives.