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Experts have stressed that paracetamol is safe to use in pregnancy
Scientists have concluded that current evidence does not link paracetamol use in pregnancy to autism. Following a new review of studies on the topic after months of controversy, experts said they hoped the findings would ‘bring the matter to a close’.
It comes after US president Donald Trump said in September there had been a ‘meteoric rise’ in cases of autism and that Tylenol – known as paracetamol in the UK – was a potential cause. He said the painkiller should not be taken during pregnancy, suggesting pregnant women should instead ‘tough it out’.
The comments were heavily criticised by politicians, autism campaigners and scientists. Now, an international team of academics, including experts from the UK, have searched databases for all studies reporting risk estimates for autism, attention-deficit hyperactivity disorder (ADHD) and intellectual disabilities.
The authors conclude that paracetamol exposure during pregnancy was ‘not associated with the risk’ of autism spectrum disorder, ADHD or intellectual disabilities.
“Current evidence does not indicate a clinically important increase in the likelihood of autism spectrum disorder, ADHD, or intellectual disability in children of pregnant individuals who use paracetamol as directed, supporting existing recommendations on its safety,” the authors wrote in the study
Some 43 studies were included in the systematic review of the data, while 17 studies were included in the meta-analysis – a research method for systematically combining findings from multiple studies.
A number of so-called sibling comparison studies were also included. These studies compare children born to the same mother, where in one pregnancy where she took paracetamol and another pregnancy she did not take paracetamol.
Study lead author, Professor Asma Khalil, consultant obstetrician and fetal medicine specialist at St George’s Hospital, London, said: “We found no clinically important increase in the risk of autism, ADHD or intellectual disability [among] children where the mothers took paracetamol during pregnancy.
“And this is the important message to the millions of pregnant individuals – paracetamol is safe to use in pregnancy. It remains to be the first-line treatment that we would recommend if the pregnant women have pain or fever in pregnancy, and it’s also consistent with recommendations or the guidelines by various national or international bodies.”
Commenting on the study, Grainne McAlonan, professor of translational neuroscience at King’s College London (KCL), said: “Expectant mothers do not need the stress of questioning whether medicine most commonly used for a headache could have far-reaching effects on their child’s health.
“This thorough and clear study approached the question by conducting both a substantial systematic review of the literature and a meta-analysis of eligible studies. Importantly, it prioritised sibling design studies to account for family history, which is crucial.
“This confirmed that there is no relationship between taking paracetamol in pregnancy and a higher likelihood of autism, ADHD or intellectual disabilities in the offspring. While the impact of last year’s announcement has been extensive, I hope the findings of this study bring the matter to a close.”
The study was published in the journal The Lancet Obstetrics, Gynaecology and Women’s Health.
