A comprehensive review published in The BMJ on November 10, 2025, concludes there is no solid evidence linking acetaminophen use during pregnancy to increased risks of autism or ADHD in children. Earlier studies suggesting a connection were found to be of low quality and influenced by family-shared factors. The findings affirm acetaminophen as a safe option for managing pain and fever in pregnancy.
In response to ongoing debates about the safety of acetaminophen—known as paracetamol outside the USA and Japan—during pregnancy, researchers conducted an umbrella review of systematic reviews. Published in The BMJ, the study analyzed nine systematic reviews encompassing 40 observational studies on prenatal acetaminophen exposure and neurodevelopmental outcomes like autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD) in offspring.
The review, led by Jameela Sheikh and colleagues from institutions including the University of Birmingham and King's College London, rated the quality of prior evidence as low to critically low. Many earlier analyses failed to adequately adjust for confounders such as shared genetics, parental health, lifestyle, and environmental factors within families. When two studies that properly controlled for these elements were examined, any observed associations between acetaminophen and the disorders largely vanished.
"The current evidence base is insufficient to definitively link in utero exposure to acetaminophen with autism and ADHD in childhood," the authors stated. They emphasized that high overlap in the reviewed studies and methodological inconsistencies further undermine previous claims of a causal link.
Despite these limitations—notably the lack of data on dosage, timing, or other neurodevelopmental outcomes—the researchers recommend continuing to use acetaminophen as the first-line treatment for pain and fever in pregnancy, aligning with global regulatory guidance. This overview highlights the need for higher-quality research to address remaining uncertainties and better inform healthcare providers and expectant mothers.