Paracetamol during pregnancy: Possible risk for autism and ADHD

Paracetamol is the most commonly used over-the-counter pain and fever reducer during Pregnancy and is experienced by more than half of pregnant women worldwide. The active ingredient is considered the safest drug option for treating headaches, fever, and other Pains .

However, the use of paracetamol during pregnancy has repeatedly been associated with a potentially increased risk of neurodevelopmental disorders in the child , such as autism spectrum disorders and attention deficit/hyperactivity disorder ( ADHD ). However, the all-clear has always been given afterward – most recently last year by a study in the journal »JAMA Network« .

An analysis of 46 studies with data from more than 100,000 participants from several countries has now found further evidence of this, underscoring the need for both caution and further research. A team led by Professor Dr. Diddier Prada of the Icahn School of Medicine at Mount Sinai in New York published the results of the study in "BMC Environmental Health."

Of the 46 studies, 27 reported positive associations, 9 showed no associations, and 4 indicated negative associations, thus a protective effect of paracetamol. Higher-quality studies were more likely to show positive associations, according to the original publication.

In an accompanying press release, Prada explicitly points out the last point, noting that given the widespread use of paracetamol in pregnancy, even a small increase in risk could have significant public health implications.

The study also investigated biological mechanisms that could explain the association between paracetamol use and these disorders. For example, paracetamol could trigger oxidative stress after crossing the placental barrier, disrupt hormone balance, or cause epigenetic changes that impair fetal brain development.

Important: The study does not show that paracetamol directly causes neurodevelopmental disorders. However, the research team's findings support the suspicion of a connection. The current recommendation is that pregnant women should use painkillers such as paracetamol in the lowest possible dose and for the shortest possible time. The researchers emphasize this with their call for cautious, time-limited use of paracetamol during pregnancy under medical supervision, updated clinical guidelines, and further research to further investigate these findings and potentially find safer alternatives for the treatment of pain and fever in pregnant women.

"Pregnant women should not stop taking medication without consulting their doctor," emphasizes Prada. "Untreated pain or fever can also harm the baby. Our study underscores the importance of talking with healthcare providers about the safest course of action and considering non-drug options whenever possible."