Global scientists push back as paracetamol-autism link draws fire from US health chiefs

Global health experts pushed back on efforts to link paracetamol to autism after President Donald Trump said he had found an answer to the condition and signaled a formal link would be announced after a federal review into rising autism rates. Paracetamol — also known as acetaminophen and sold in the United States as Tylenol — is widely used by pregnant people to treat pain, headaches and fever. Dozens of studies have linked the drug to higher rates of autism and ADHD, though findings have not been consistently replicated.

Trump, speaking during a detour at Charlie Kirk's memorial service in Arizona, suggested an announcement on autism and said his administration had found an answer. The review into drivers of rising autism rates was launched by US health secretary Robert F Kennedy Jr.

Global health experts responded with caution, arguing there is no proven causal link between paracetamol use in pregnancy and autism. Dr Monique Botha, an associate professor in social and developmental psychology at Durham University, said there is no robust evidence or convincing studies to support a causal relationship. She stressed that pain relief for pregnant people is important and that paracetamol remains a safer option than many alternatives when used at the lowest effective dose for the shortest possible period. The fear of a link, she warned, could deter pregnant people from seeking appropriate care and may stigmatise families.

Dr Hannah Kirk, a senior lecturer in developmental psychology at Monash University, said no study has shown that paracetamol causes autism. Some studies show an association, others do not, and association does not equal causation. A recent large-scale study analyzing data from 2.48 million births found that when researchers compared siblings to control for genetic and environmental factors, the apparent links between paracetamol and autism disappeared. This suggests other factors, such as genetic or maternal health conditions, may better explain the findings. Fever itself has been linked to adverse pregnancy outcomes, and treating fever with paracetamol may reduce risks. Pregnant people should continue to follow the guidance of their health care providers when managing pain and fever.

Prof Stephen Griffin, an infectious disease expert at the University of Leeds, said the argument that paracetamol causes autism places blame on parents and is unfounded. He described autism as a complex, polygenic, largely unpredictable syndrome. Prof Dimitrios Siassakos, an obstetrics and gynaecology expert at University College London, warned that undue focus on paracetamol could keep families from using one of the safest medications available in pregnancy when needed.

The president’s remarks came amid ongoing political attention to autism research. Officials say the federal review into rising autism rates remains focused on understanding drivers of prevalence, and not on assigning blame to expectant parents. In parallel, researchers from Mount Sinai and Harvard School of Public Health recently urged that pregnant women consult doctors and use paracetamol sparingly, citing analysis of more than 100,000 pregnancies as the strongest evidence to date of an association—while again stressing that the findings do not prove causation and call for further study. Dr Diddier Prada, an author of that work, noted that even a small increase in risk could have large public health implications given the medication’s widespread use. He urged continued dialogue with health care providers and consideration of non-drug options when possible.

Paracetamol is currently recommended by the NHS as the first choice painkiller for expectant mothers, but for short periods and at the lowest effective dose. In the UK, about half of pregnant women take paracetamol, while in the United States the figure is around 65 percent. Health officials caution that certain people, such as those with liver or kidney disease or those taking epilepsy medications, should exercise extra caution. NHS data show the health service has faced strain in other areas, with almost 130,000 under-18s in England waiting for an assessment in December 2024, a situation described by some experts as an invisible crisis that strains families and services.

Autism is not a disease; it is present from birth and exists on a spectrum. Some individuals can live independently with minimal support, while others require ongoing care. The latest discussions around paracetamol are part of broader debates about how to balance effective symptom relief during pregnancy with the need for rigorous evidence on any potential risks. Researchers emphasize that while inquiries into potential links warrant careful study, exceptional care should be taken to avoid stigmatizing families or deterring necessary medical care during pregnancy.