Understanding the Risks of Acetaminophen Use During Pregnancy: What You Need to Know

A pregnant woman rests in contemplation, highlighting concerns about the risks of acetaminophen use during pregnancy and its potential link to autism.

This is not a political statement or medical advice. Please form your own opinion based on the information provided. Consult your obstetrician to determine the safe dosage of acetaminophen for you.

Recent reviews have examined how using acetaminophen during pregnancy might affect children's brain development. This is especially true for conditions like autism spectrum disorder (ASD). The best evidence comes from large studies that also consider other factors, such as family history and genetics.

Studies on the Risk of Autism and Exposure to Acetaminophen in Pregnancy

Systematic Review Findings

A systematic review from 2025 utilized the Navigation Guide method. It found that most studies indicated a link between taking acetaminophen while pregnant and a higher risk of neurodevelopmental disorders (NDDs), including ASD and ADHD. However, the review noted significant differences across studies and potential biases. While higher-quality studies generally found a positive link, the review concluded that there is an association but not necessarily a direct cause. It recommended caution when using acetaminophen during pregnancy.[1]

Meta-Analyses Insights

Meta-analyses of cohort studies have indicated a slightly increased risk of Autism Spectrum Disorder (ASD). The pooled risk ratio was found to be 1.19 (95% Confidence Interval: 1.14–1.25). This suggests a small link between acetaminophen and ASD. However, these results have limitations, as they stem from observational studies that can be influenced by other confounding factors.[2][3]

Sibling-Controlled Studies

The largest and most recent study examined the relationship between acetaminophen use and the risk of Autism Spectrum Disorder (ASD). This study included a special analysis that considered siblings. Here are the main points:

• When accounting for family-related factors, the link between acetaminophen use and ASD risk disappeared.

• This suggests that earlier findings, which indicated a connection between acetaminophen and ASD, may not reflect a true cause-and-effect relationship.[4]

  
  

For instance, both ice cream sales and sunburns increase during the summer. This indicates an association between the two. However, it does not mean that eating ice cream causes sunburns. They are merely correlated due to a third, unmeasured factor: sunlight. Similarly, while there is an association between cigarette smoking and cancer, extensive research has ruled out confounding factors, establishing that cigarettes are a causative factor for cancer.

Risk Assessment

The figure below from the 2024 JAMA study illustrates the absolute risk difference for autism at 10 years of age between children exposed and unexposed to acetaminophen during pregnancy. The risk increase is minimal (0.09%) and disappears in sibling-controlled analyses. This supports the current consensus that acetaminophen use in pregnancy is unlikely to confer a clinically meaningful increased risk of ASD.

Summary of Findings on Prenatal Acetaminophen Use

Earlier systematic reviews and meta-analyses showed a small link between using acetaminophen during pregnancy and certain neurodevelopmental outcomes in children. However, biases due to external factors were not ruled out in those studies. The strongest evidence to date suggests that taking acetaminophen while pregnant is unlikely to lead to autism. Therefore, scientists have recommended that acetaminophen is safe to use during pregnancy.[5][4][1][2][3]

Making Informed Decisions

As you navigate your pregnancy, it is essential to make informed choices. While the current evidence suggests that acetaminophen is generally safe, always consult your obstetrician for personalized advice. They can guide you on the correct dosage and any potential risks based on your unique circumstances.

The Importance of Consultation

Your healthcare provider is your best resource for understanding the implications of medication use during pregnancy. They can help you weigh the benefits and risks, ensuring that you make the best decisions for your health and your baby's well-being.

Empowering Yourself with Knowledge

Staying informed about your health choices is crucial. By understanding the latest research and recommendations, you can empower yourself to make the right decisions. Remember, your health is a priority, and seeking guidance from professionals is a step in the right direction.

References

1. Evaluation of the Evidence on Acetaminophen Use and Neurodevelopmental Disorders Using the Navigation Guide Methodology. Prada D, Ritz B, Bauer AZ, Baccarelli AA. Environmental Health: A Global Access Science Source. 2025;24(1):56. doi:10.1186/s12940-025-01208-0.

2. Prenatal Exposure to Acetaminophen and Risk for Attention Deficit Hyperactivity Disorder and Autistic Spectrum Disorder: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Cohort Studies. Masarwa R, Levine H, Gorelik E, et al. American Journal of Epidemiology. 2018;187(8):1817-1827. doi:10.1093/aje/kwy086.

3. Analgesic Drug Use in Pregnancy and Neurodevelopment Outcomes: An Umbrella Review. Kwok J, Luedecke E, Hall HA, Murray AL, Auyeung B. Neuroscience and Biobehavioral Reviews. 2022;136:104607. doi:10.1016/j.neubiorev.2022.104607.

4. Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. Ahlqvist VH, Sjöqvist H, Dalman C, et al. JAMA. 2024;331(14):1205-1214. doi:10.1001/jama.2024.3172.

5. Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder. Damkier P, Gram EB, Ceulemans M, et al. Obstetrics and Gynecology. 2025;145(2):168-176. doi:10.1097/AOG.0000000000005802.