Does taking paracetamol during pregnancy increase the risk of autism? Experts' overwhelming opinion on Trump's announcement

The Donald Trump administration plans to announce this Monday that the use of acetaminophen during pregnancy is potentially linked to autism , and will therefore advise against its use in women in the early stages of pregnancy unless they have a fever, The Washington Post reported. In addition, the White House will recommend a drug called leucovorin as a treatment for autism, the article adds.

The US president revealed on Saturday that his administration would make an announcement on the autism findings this Monday, though he declined to offer details. "I think it will be a very important announcement. I think it will be one of the most important things we'll ever do," Trump said at a dinner hosted by the conservative American Cornerstone Institute.

The Wall Street Journal reported this month that Health and Human Services Secretary Robert F. Kennedy Jr. , known for his anti-vaccine stance, plans to announce that use of Tylenol, a popular over-the-counter acetaminophen in the U.S., by pregnant women is potentially linked to autism, contrary to medical guidelines establishing its safety.

«There are many studies that refute this correlation, but the most important was a Swedish study of 2.4 million births (1995-2019) published in 2024 , which used real-world sibling data and found no relationship between in-utero paracetamol exposure and later autism, ADHD, or intellectual disability. This suggests no causal effect of paracetamol on autism . This is reinforced by the absence of a dose-dependent relationship. There is no strong evidence or convincing studies to suggest a causal relationship, and conclusions drawn to the contrary are often motivated, lacking in evidence, and not supported by the most robust methods for answering this question. I am exceptionally confident that there is no relationship,» Monique Botha, Associate Professor of Social and Developmental Psychology at Durham University (UK), told SMC Spain .

The expert believes that paracetamol is a much safer option for pain relief during pregnancy than virtually any other alternative. "Scaremongering will prevent women from accessing appropriate care during pregnancy. Furthermore, it risks stigmatizing families with autistic children as if they themselves caused it, and rekindling the old pattern of shame and maternal guilt that we have seen resurface repeatedly over the past 70 years, in which attempts are made to somehow blame the mother for autism," she concludes.

Along the same lines, the Spanish Society of Pediatric Neurology (SENEP) makes it clear that "there is no solid evidence to establish a causal relationship between paracetamol use during pregnancy and autism spectrum disorder." And it calls for caution in the face of "claims not supported" by conclusive data to avoid generating social alarm. The president of SENEP, Marcos Madruga, asserts that the most scientifically rigorous studies have not found this relationship and attributes the suspicion to research that did not take into account confounding factors such as genetic predisposition or maternal illnesses that led to the use of the drug during pregnancy. "While there may be an association in the frequency of both, no study establishes a cause-effect relationship," he indicates.

Dr. Aránzazu Hernández-Fabián, a neuropediatrician and member of the ADHD and Neurodevelopmental Disorders Working Group at Senep, points out that autism spectrum disorder (ASD) is a condition of early neurodevelopment. "Autism is a condition that accompanies a person throughout their life. It's not a disease; it's neurodiversity," she asserts.

"People with autism present challenges in their communication and socialization, as well as repetitive behaviors, restricted interests, decreased tolerance for change, and atypical sensory responses," explains the neuropediatrician. Furthermore, it is considered a spectrum because each person with autism is unique, with their own strengths and needs, requiring different levels of support throughout their lives."

There has been a 300% increase in diagnoses in the last two decades, largely, according to the Senep expert, due to improved access to diagnosis, the inclusion of people on the autism spectrum with less obvious symptoms that interfere with their daily lives, and "perhaps also due to the increase in some risk factors related to ASD," explains Dr. Hernández-Fabián.

“Autism is the result of several factors, often combined, in particular, genetic predisposition and, occasionally, a lack of oxygen at birth due to complications. Research has shown that any apparent marginal increase resulting from paracetamol use during pregnancy tends to disappear when analyses account for the most important factors. For example, in studies that looked at siblings, any association disappeared: what mattered was family history, not paracetamol use. An undue focus on paracetamol could prevent families from using one of the safest pregnancy medications when needed,” agrees Dimitrios Siassakos, Professor of Obstetrics and Gynecology at University College London and Honorary Consultant in Obstetrics at University College London Hospital, in a statement to SMC Spain.

Regarding the use of leucovorin (folic acid) as a treatment for autism, the president of the Spanish Society of Pediatric Neurology states that there is no recommendation for its use in autism. He emphasizes that management is multidisciplinary and "no drug has been shown to be effective against the causes of autism in general."

Monique Botha reiterates this argument: "The evidence available at this time is exceptionally tentative and not considered robust. Similarly, while medications can help in very specific ways, there is no single medication or treatment that actively cures or eliminates autism , although it can adjust behavior or reduce the co-occurring symptoms that contribute to the distress of autistic people."

Autistic people are exceptionally heterogeneous, so any treatment or medication for specific traits "is likely to work for very specific manifestations of autistic traits, in very specific contexts. General claims about cures or treatments are often not accurate, useful, or ethical," concludes the associate professor of Social and Developmental Psychology at Durham University (United Kingdom).