Current evidence base insufficient to definitively link acetaminophen use in pregnancy with autism, ADHD in offspring
By Elana Gotkine HealthDay Reporter
MONDAY, Nov. 17, 2025 (HealthDay News) — Maternal acetaminophen use during pregnancy is not clearly linked with autism or attention-deficit/hyperactivity disorder (ADHD) in offspring, according to a review published online Nov. 10 in The BMJ.
Jameela Sheikh, M.B.Ch.B., from the University of Liverpool in the United Kingdom, and colleagues conducted an umbrella review of systematic reviews to examine the quality, biases, and validity of evidence on maternal acetaminophen use during pregnancy and the risk for autism and ADHD in offspring. Nine reviews (40 studies) reporting on autism (six studies) and ADHD (17 studies) in offspring were included; a meta-analysis was conducted for four reviews.
There was very high overlap of primary studies included in the reviews (corrected covered area, 23 percent). The researchers found a possible to strong association between maternal acetaminophen intake and autism or ADHD or both in offspring as reported by the reviews. When interpreting the findings, caution was advised by seven of the nine reviews due to a potential risk for bias and confounding in the studies. Low to critically low confidence in the findings of the reviews was reported (two and seven reviews, respectively). Only one review included studies (two studies) that appropriately adjusted for familial factors and unmeasured confounding via sibling-controlled analyses; in these studies, the increased risk for autism and ADHD seen in the whole cohort analyses did not persist in sibling-controlled analyses.
“High-quality studies that control for familial and unmeasured confounders can help improve evidence on the timing and duration of paracetamol [acetaminophen] exposure, and for other child neurodevelopmental outcomes,” the authors write.
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