The US government has strengthened the position that paracetamol use during pregnancy increases the risk of autism and ADHD, even though a major scientific review found no evidence to support this theory.
Last week, the prestigious medical journal The Lancet published a new analysis that refuted claims made last year by US President Donald Trump that the widely used painkiller could harm the developing brain of the fetus. The review was welcomed by health experts around the world and concluded that paracetamol should remain the first choice for treating pain and fever during pregnancy.
The study authors also pointed out that the debate around this over-the-counter drug has been politicized, creating confusion among both pregnant women and doctors.
However, following the publication of the study, the US Department of Health and Human Services told the Daily Mail that "many experts have expressed concerns" about paracetamol - known in the US as acetaminophen or Tylenol.
Department spokesman Andrew Nixon referred to previous statements by Dr. Andrea Baccarelli, dean of the Harvard School of Public Health, who has suggested that there is a "cause-and-effect relationship" between paracetamol use during pregnancy and neurodevelopmental disorders.
Dr. Baccarelli is a renowned researcher in the field of environmental health, and his studies are based primarily on observational research, not controlled clinical trials – an important distinction in assessing the strength of scientific evidence.
These observational studies are part of a broader scientific debate, to which US Health Secretary Robert F. Kennedy Jr. and President Trump referred in September when they claimed that paracetamol was behind the "meteoric" rise in autism diagnoses - a conclusion strongly disputed by many scientists.
Sources close to the US administration have suggested that the authors of The Lancet review did not consider all the available evidence and have accused them of delays in taking measures that could protect public health.
To reach their conclusions, the obstetrician-gynecologists who conducted the review analyzed 43 studies on the possible link between paracetamol use during pregnancy and neurodevelopmental disorders, including autism. Particular weight was given to so-called “sibling studies,” which compare children from the same family, where one was exposed to paracetamol in the womb and the other was not.
The aim of this method is to minimise the influence of genetic and environmental factors, as autism and ADHD are known to run in families. Based on this approach, the authors found “no significant association” between paracetamol use in pregnancy and autism.
Many independent experts called the review “robust and reliable,” praising the rigorous methods used. However, the director of the US National Institutes of Health, Dr. Jay Bhattacharya, has been critical of sibling studies, calling them in some cases “naïve.” According to him, this method excludes families where all children have had the same exposure, which can lead to an underestimation of risk.
Responding to the criticism, Professor Asma Khalil, professor of obstetrics and fetomaternal medicine at City St George's University in London and lead author of the review for The Lancet, stressed that their study does not exclude evidence but systematically evaluates it all, giving more weight to designs that reduce bias and confounding factors - a standard practice in evidence-based medicine.
She added that previous links between paracetamol and neurodevelopmental problems have been weakened or eliminated when more robust analytical methods have been used, and that the review's conclusions are based on the consistency of results from many rigorous analyses.
Currently, around half of pregnant women in the UK use paracetamol for pain, headache or fever, while in the US this figure is around 65%. The drug has long been considered safe and effective when used as directed.
Autism is a lifelong neurodevelopmental disorder that affects the ability to understand social cues and express oneself. Once considered rare, the number of diagnoses has increased dramatically over the past 20 years – nearly 800% according to the Journal of Child Psychology and Psychiatry. Today, more than one in 100 people in the UK are on the autism spectrum, according to the National Autism Society. /GazetaExpress/
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