New Review Dismisses Link Between Acetaminophen and Autism Risk

A comprehensive review published in the BMJ has found no definitive link between the use of acetaminophen during pregnancy and the development of autism spectrum disorder or attention deficit/hyperactivity disorder (ADHD) in children. This research comes amid ongoing public concerns and claims from the previous administration in the United States urging caution regarding the medication’s use during pregnancy.

Researchers from the University of Liverpool analyzed data from 40 studies conducted globally over the past decade. Although earlier studies suggested a possible association between prenatal acetaminophen use and neurodevelopmental disorders, many of these studies acknowledged limitations such as bias, insufficient study design, and failure to consider familial factors that might influence outcomes.

The review authors indicated that confidence in previous findings was rated as low to critically low based on AMSTAR 2, a recognized tool for assessing systematic review quality. They noted issues such as the absence of detailed protocols, incomplete searches of the literature, and inadequate controls for confounding variables.

Reassessing Previous Findings

The team highlighted two high-quality sibling control studies conducted in Sweden and Norway. These studies compared siblings where one pregnancy involved acetaminophen exposure while the other did not. Initial observations of increased autism or ADHD risk disappeared when considering genetic and shared environmental influences.

Lead author Professor Shakila Thangaratinam emphasized that familial factors likely account for much of the apparent association identified in broader population studies. The findings are particularly relevant given recent directives calling for pregnant women to avoid acetaminophen due to fears it may contribute to autism.

Medical experts and regulatory agencies in the United States, United Kingdom, European Union, and Australia have reassured expectant mothers that acetaminophen remains the safest recommended treatment for fever and pain during pregnancy.

Implications for Women’s Health Research

The researchers warned that avoiding acetaminophen in cases of high fever could pose greater risks to both mother and child, potentially leading to poor pregnancy outcomes. They underscored that the lack of robust, well-controlled studies reflects an ongoing issue in women’s health research, specifically the underinvestment in rigorous trials during pregnancy.

The authors advocated for future research to carefully measure drug exposure, utilize validated diagnostic tools, and employ various analytical methods to minimize bias. By addressing these gaps, the scientific community can better understand the implications of medication use during pregnancy and ensure the health and safety of both mothers and their children.