Taking acetaminophen during pregnancy is not clearly linked to autism or attention-deficit/hyperactivity disorder (ADHD) in children, according to a new review.
The issue has been in the headlines since September, when President Donald Trump warned that acetaminophen use during pregnancy was “associated with a greatly increased risk of autism” and the president advised pregnant women: “Don’t take Tylenol.”
At the time, federal officials cited a August 2025 Meta-Analysis from researchers at Mt. Sinai, the Harvard TH Chan School of Public Health, the UCLA Fielding School of Public Health, and the University of Massachusetts Lowell who found that prenatal exposure to acetaminophen may be associated with increased rates of neurodevelopmental disorders, including autism and ADHD, in children.
However, the new analysis published Sunday in BMJ also examined a wide range of previously published reviews and found no such clear evidence.
As part of the new analysis, researchers from the United Kingdom, Spain and Australia examined nine systematic reviews that reported the results of 40 studies that examined maternal use of over-the-counter pain relievers during pregnancy and child neurological development.
Those nine reviews found a potential association between the use of acetaminophen, also known as paracetamol, by pregnant people, and “adverse neurodevelopmental outcomes.”
The team found that seven of the nine reviews cautioned against establishing a causal link between drug use during pregnancy and autism, ADHD, or both.
Generic acetaminophen tablets.
Jorge Martínez/Getty Images
Additionally, they found that many of the nine reviews had critical flaws, such as not conducting a comprehensive search of the scientific literature, not listing excluded studies and the reason for their exclusion, inaccurate study designs, and the use of non-standard tools to assess risk of bias, according to the new review.
Dr. Shakila Thangaratinam, a co-author of the new review and executive dean of the Institute of Life Course and Medical Sciences at the University of Liverpool in the United Kingdom, said the new analysis was partly a response to Trump’s September announcement in a White House press conference that acetaminophen use by pregnant people could increase the risk of autism in their children, contradicting many previously published studies that have found no causal link.
The president has since repeated that claim on social media and suggested that young children, including infants, should not be given the medication, known by the brand name Tylenol, without providing evidence to support the claim.
Thangaratinam said the US announcement “gained enormous media attention, meaning it became a key part of healthcare conversations, with paracetamol being the most common medication taken by women during pregnancy.”
“We wanted to look at all the evidence in the space, look at the quality, make sense of it and interpret it, in a way that would help healthcare providers in conversations with women and their families,” Thangaratinam continued.
She added that, as a consultant obstetrician, she is concerned that pregnant people may postpone using paracetamol due to high fever or severe pain, which can lead to serious complications for both mother and fetus.
Additionally, Thangaratinam said there is concern that pregnant people may turn to other over-the-counter medications, such as ibuprofen, which are not considered safe to use during pregnancy.
Major medical groups, such as the American College of Obstetricians and Gynecologists (ACOG) strongly rejected the president’s claim linking acetaminophen during pregnancy to autism, calling it “very concerning,” “irresponsible” and “not supported by all scientific evidence.”
For the new review, the researchers found that many of the studies in the nine reviews examined did not adjust for other contributing factors, such as genetics, maternal health, and external environmental factors.
Only one of the nine reviews It included studies that took into account shared family factors using a sibling control analysis, which looks at whether an apparent link is due to shared genetics and family environment. The studies in that review found that when adjusted for sibling control, any association between Tylenol use by pregnant people and autism or ADHD missing, according to Thangaratinam.
Donald Trump attends a dinner with the leaders of the C5+1 Central Asian countries: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan, in Washington, DC, on November 6, 2025.
Nathan Howard/Reuters
He said this means it is very likely that the association that was initially observed was driven by shared familial, genetic and environmental factors, as well as unmeasured factors, rather than being driven by acetaminophen use during pregnancy.
Furthermore, many of the reviews examined the same studies for their analyses.
The researchers rated these nine reviews as “low” or “critically low” in the confidence of their findings, meaning that they cannot or cannot be “relied on to provide an accurate and complete summary of the available studies.”
Thangaratinam said the debate over acetaminophen use during pregnancy highlights the lack of medications developed and approved to treat pain, fever and other medical conditions in pregnant women.
“One of the reasons why paracetamol is one of the few medications we can administer [to pregnant women] “There’s not a lot of research on the safety of medications during pregnancy, and many of the medications, when they’re in the testing phase, actually exclude pregnant women,” she said. “Which means that pregnant women [may] We never really get the chance to access the medications that could really help them get better. …Therefore, there is a need to focus on drug discovery, as well as science, during pregnancy.”
