Paracetamol is one of the most commonly used medicines to reduce pain and fever. It is also widely recommended during pregnancy when needed because it is generally considered safer than many other painkillers. However, over the past few years, several studies raised concerns that taking paracetamol while pregnant might increase a child's risk of developing autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD). These studies have raised doubts whether expecting mothers should use the medicine.
Now, a new study published in JAMA Internal Medicine says that there's no evidence that using paracetamol during pregnancy causes autism or ADHD in children. The researchers also accounted for family-related factors that may have had an impact on earlier findings. This study is one of the largest and most detailed investigations on the topic and the findings provide strong evidence that doctor-recommended use of paracetamol during pregnancy is not linked to these neurodevelopmental conditions.
What Did The New Study Find?
The researchers analysed health records of more than 7,08,000 mother-child pairs in Hong Kong collected over two decades. They then carried out a sibling comparison, looking at families where one sibling was exposed to paracetamol during pregnancy while another was not. This method helps reduce the effects of shared genetic and environmental factors that could otherwise impact the results.
After comparing siblings, the researchers found no increased risk of either autism or ADHD among children exposed to paracetamol before birth. The findings remained the same regardless of when during pregnancy the medicine was taken, how much was used, or how often it was prescribed.
Why Were Earlier Studies Different?
Previous studies suggested a possible link between prenatal paracetamol use and neurodevelopmental disorders. However, those studies could not fully separate the effects of the medicine from other factors.
For example, women who take paracetamol during pregnancy may have infections, fever, chronic pain, or other health conditions that themselves could influence a child's development. Genetic factors and family environments may also play a role. The new sibling-matched design was able to control for many of these hidden influences, making the findings more reliable.
Also, when researchers looked at the data using traditional methods, they again found an apparent link. However, once they compared siblings and adjusted for family-related factors, that link disappeared. This suggests that earlier findings were likely explained by these confounding factors rather than the medicine itself.
What Does This Mean For Pregnant Women?
The study offers reassurance for pregnant women who need paracetamol to manage pain or fever. Doctors have long advised that untreated high fever during pregnancy can also carry risks for both the mother and the developing baby. Therefore, avoiding necessary treatment out of fear may not be the safest choice. Experts say the findings support current medical advice that paracetamol is an appropriate option during pregnancy when used for a genuine medical need, at the lowest effective dose, and for the shortest possible duration.
Does This Settle The Debate?
While there's ongoing research on medicines used during pregnancy, this study provides some of the strongest evidence so far on paracetamol's safety regarding autism and ADHD risk. The large sample size, long follow-up period, and sibling comparison approach make the findings convincing. While no single study can answer every question, this research adds to the growing evidence which shows that paracetamol itself is unlikely to be the cause of autism or ADHD.
The latest JAMA study provides a clear and reassuring message: using paracetamol during pregnancy, when medically indicated, does not increase the risk of autism or ADHD in children. Expecting mothers can still use paracetamol in a responsible way and only when needed.
"In this population-based cohort study, a sibling-matched analysis found no evidence of an association between prenatal paracetamol exposure and the risk of ASD or ADHD in offspring. The positive signals observed in conventional studies are likely attributable to residual familial confounding. These findings provide important reassurance regarding the safety of indicated paracetamol use during pregnancy," the authors wrote.
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