United States President Donald Trump recently advised pregnant women to avoid paracetamol unless facing extremely high fever, citing potential links to autism. However, Australia's Therapeutic Goods Administration reaffirmed on Tuesday that paracetamol remains safe throughout pregnancy. The medication, known as acetaminophen or Tylenol in the US, is classified as a Category A drug, meaning it has been used extensively without causing birth defects or foetal harm. Treating fevers during pregnancy is crucial, as untreated high temperatures in early pregnancy are associated with miscarriage, neural tube defects, cleft lip and palate, and heart defects. Recent research reviews have examined potential links between paracetamol and neuro-developmental disorders like autism and ADHD. While some studies suggest associations, sophisticated analyses accounting for genetic and environmental factors find no increased risk. Medical guidance recommends using paracetamol at the lowest effective dose for the shortest time when needed during pregnancy.
Research Findings on Paracetamol and Neuro-Developmental Risks
A 2021 international panel reviewed evidence and warned paracetamol might alter foetal development. Last month, Harvard researchers analysed 46 studies: 27 reported links between paracetamol and neuro-developmental disorders, nine found no significant connection, and four indicated lower risk. A notable 2024 Swedish study of nearly 2.5 million children born between 1995 and 2019 initially found marginally increased autism and ADHD risk. However, when researchers compared matched sibling pairs to account for shared genetic and environmental factors, they found no evidence of increased autism, ADHD, or intellectual disability risk. Siblings of autistic children have a 20 per cent chance of also being autistic. A February review concluded that when confounding factors were properly accounted for, associations weakened substantially, suggesting original findings may reflect shared family characteristics rather than paracetamol use.
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