A new report is at the centre of the controversy
UK experts have slammed “fearmongering” in the US after reports emerged that Donald Trump’s administration will claim there is a connection between paracetamol use during pregnancy and autism. Scientists have struck back, with one stating the assertion “risks stigmatising families who have autistic children as having brought it on themselves”.
The Wall Street Journal revealed that US health secretary Robert F Kennedy Jr is expected to declare Tylenol – which is paracetamol in the UK – as a potential cause of autism. The publication said a federal report is also anticipated to recommend a specific type of the vitamin folate as a method to treat the condition.
Mr Trump said on Saturday: “I think we found an answer to autism.”
In the UK, the NHS website states “paracetamol is the first choice of painkiller if you’re pregnant. It’s commonly taken during pregnancy and does not harm your baby”.
Dr Monique Botha, associate professor in social and developmental psychology at Durham University, said: “There are many studies which refute a link, but the most important was a Swedish study of 2.4 million births published in 2024 which used actual sibling data and found no relationship between exposure to paracetamol in utero and subsequent autism, ADHD or intellectual disability. This suggests no causal effect of paracetamol in autism.”
‘No evidence’
Dr Botha said: “There is no robust evidence or convincing studies to suggest there is any causal relationship and any conclusions being drawn to the contrary are often motivated, under-evidenced, and unsupported by the most robust methods to answering this question. I am exceptionally confident in saying that no relationship exists.
“Similarly, pain relief for pregnant women is woefully lacking and paracetamol is a much safer pain relief option during pregnancy than basically any other alternative and we need to take pain seriously for women, including whilst pregnant.
“The fearmongering will prevent women from accessing the appropriate care during pregnancy. Further, it risks stigmatising families who have autistic children as having brought it on themselves and reinvigorates the long pattern of maternal shame and blame as we’ve seen re-emerge repeatedly over the last 70 years where we try to pay the fault of autism at the mother’s door one way or another.”
‘Undue focus’
Dimitrios Siassakos, professor in obstetrics and gynaecology at University College London and honorary consultant in obstetrics at University College London Hospital (UCLH), said: “Autism results from several factors, often combined, particularly genetic predisposition, and sometimes low oxygen at the time of birth as a result of complications.
“Research has shown that any apparent marginal increase as a result of paracetamol/acetaminophen use in pregnancy tends to disappear when the analyses take into account the factors that matter most. For example, in studies looking at siblings, any association disappeared – it was the family history that mattered and not the use of paracetamol. Undue focus on paracetamol would risk preventing families from using one of the safest medications to use in pregnancy when needed.”
Professor Claire Anderson, president of the Royal Pharmaceutical Society, said: “Paracetamol has been used safely by millions of people for decades, including during pregnancy, when taken as directed. It is the first-line choice for pain management and fever control in a variety of patients, including pregnant women, children and the elderly.
“A large study conducted in 2024 found no evidence of a link between paracetamol use in pregnancy and an increased risk of autism in children. This research, which followed over 2.4 million children, provides reassurance for expectant parents that paracetamol remains a safe option for managing pain or fever during pregnancy when used as recommended.”
In August this year, a study from Harvard TH Chan School of Public Health and Mount Sinai reported that exposure to acetaminophen, which is also known as Tylenol or paracetamol, during pregnancy may mean children were more likely to develop neurodevelopmental disorders including autism and ADHD.
Published in BMC Environmental Health, the researchers analysed results from 46 previous studies. They concluded that, while steps should be taken to limit acetaminophen use, the drug was important for treating fever and pain in mothers, which could also harm babies.
“We recommend judicious acetaminophen use – lowest effective dose, shortest duration – under medical guidance, tailored to individual risk-benefit assessments, rather than a broad limitation,” they said.
Angelica Ronald, professor of psychology and genetics at the University of Surrey, said: “There is a lot of empirical evidence from many decades of robust research, conducted across a range of countries, that does not support the claim that paracetamol causes autism.
“Twin studies show that in fraternal (also known as dizygotic) twins, if one twin has autism, typically the other twin does not have autism. If paracetamol caused autism, we would see both twins in a pair having autism.
“However, that is not the case – typically one fraternal twin has autism and the other does not. Molecular genetic research has uncovered hundreds of genes that cause or influence likelihood of developing autism. There are many forms of autism, some of which are caused by known genetic differences. This evidence is also incompatible with the idea that paracetamol is a major cause of autism.”
Dr Edward Mullins, clinical associate professor at The George Institute for Global Health, Imperial College London, said: “The best available evidence is that paracetamol use in pregnancy is not linked to autism. In the absence of any new evidence, the reported press release from the Trump administration claiming it is would appear to be an unsubstantiated theory which is likely to lead to an essential treatment for fever and pain being denied to women in pregnancy without good reason, contrary to US and European medical guidance.”