Related Experiment Video
Updated: Jun 12, 2025
Author Spotlight: Collecting the Brain and Serum from the Same Mice Fetus to Study Brain Tumor Development
Published on: May 17, 2024
Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder
Per Damkier1, Erika B Gram, Michael Ceulemans
1Department of Clinical Pharmacology, Odense University Hospital, and the Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Clinical Pharmacology & Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; Radboud University Medical Center, Nijmegen, the Netherlands; Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, and the Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; the Pharmacy Department, Rotunda Hospital and School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; the Department of Pediatrics, University of California San Diego, La Jolla, California; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Pharmakovigilanzzentrum, Embryonaltoxikologie, Institut für Klinische Pharmakologie und Toxikologie, Berlin, Germany; Mothersafe, University of New South Wales, Australia; UK Teratology Information Service and the Directorate of Women's Services, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom; the Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington; the Israeli Teratology Information Service, Ministry of Health, and the Hebrew University Hadassah Medical School, Jerusalem, Israel; the Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida; and the Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.
Maternal acetaminophen use during pregnancy is unlikely to increase a child's risk for attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). Current evidence suggests biases in studies showing a link, not a true clinical risk.
Area of Science:
- Perinatal pharmacology and neurodevelopmental disorders.
Background:
- Acetaminophen (paracetamol) is a widely used analgesic and antipyretic during pregnancy.
- Concerns exist regarding potential neurodevelopmental effects, specifically attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), following in utero exposure.
Purpose of the Study:
- To critically evaluate the existing scientific literature on the association between maternal acetaminophen use during pregnancy and the risk of ADHD and ASD in children.
- To assess the quality of evidence and identify limitations in published studies.
Main Methods:
- Systematic review and critical appraisal of published studies and meta-analyses.
- Inclusion criteria focused on studies with validated ADHD or ASD outcome definitions.
- Analysis of nine original data studies and three meta-analyses, with particular attention to confounding factors.
Main Results:
- Many studies reporting a positive association between acetaminophen exposure and ADHD/ASD risk suffer from significant biases, including selection bias and inadequate control for confounders.
- When familial confounding (shared genetics and environment) was addressed using sibling analyses, the observed associations substantially weakened.
- The current body of evidence suggests that in utero acetaminophen exposure does not confer a clinically significant increased risk for childhood ADHD or ASD.
Conclusions:
- The existing scientific evidence does not support a clinically important link between maternal acetaminophen use in pregnancy and increased risk of ADHD or ASD in children.
- Current clinical guidelines for managing pain or fever during pregnancy do not require revision based on this evidence.
- Further prospective research is needed to investigate potential confounding factors, including familial and psychosocial influences on both maternal medication use and child neurodevelopment.
More Related Videos
10:02Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
Published on: March 12, 2020
19:15Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Related Concept Videos
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
01:07Teratogenicity
01:23Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
01:28Human Genetics
The complex relationship between genetics and psychology is observable through common biological components such...