Key takeaways:
- A new systematic review found no causal link between prenatal acetaminophen use and increased risk of neurodevelopmental disorders in children.
- The findings support current guidance from the CDC, ACOG, and the Society of Obstetricians and Gynecologists of Canada on the safe use of acetaminophen during pregnancy.
- ADHD and autism spectrum disorder risks were not elevated after adjusting for study design factors, including sibling comparisons.
- Minor associations seen in some analyses were linked to data source differences, with maternal recall shown to be more reliable than patient-chart data.
- Investigators emphasized the need for future studies to improve accuracy in exposure measurement, dosage tracking, and confounder control.
Offspring neurodevelopmental disorder (NDD) risk is not increased by acetaminophen use during pregnancy, according to a recent study published in the Journal of the American Academy of Child & Adolescent Psychiatry.1
These data support recommendations for prenatal acetaminophen use by the CDC, American College of Obstetricians and Gynecologists, and The Society of Obstetricians and Gynecologists of Canada. Investigators concluded there is not a causal link between acetaminophen use and the observed increase in attention-deficit/hyperactivity disorder (ADHD).
“An integrative approach, summarizing the present state of knowledge and quantifying specific methodological areas of biases, as our study does, is needed in order to have a significant impact on future studies performed,” said Anick Bérard, PhD, a professor at the University of Montreal in Quebec, Canada.
Assessing prenatal acetaminophen exposure and NDDs
The systematic review was conducted to evaluate the link between acetaminophen use during pregnancy and NDDs.2 Articles published through August 26, 2025, were obtained through searches of the Medline, PubMed, PsycINFO, Embase, all EBM Reviews, Web of Science, and EBSCO CINAHL Complete databases.
Any study assessing the link between prenatal acetaminophen use and offspring NDD risk was eligible for inclusion. Two independent reviewers performed title and abstract screening, followed by full-text screening, with a subgroup of other team members consulted to resolve discrepancies.
Children without in utero acetaminophen exposure were included as a reference group. Physician-based diagnoses of NDDs were performed using International Statistical Classification of Diseases, Ninth Revision and Tenth Revision codes, with measurements from psychometric instrument scales also included.
A diverse patient population was reported across the selected studies, alongside variations in follow-up duration. The definition of acetaminophen use was exposure during pregnancy in all of the included studies.
ADHD risk analysis shows no causal association
The link between acetaminophen use during pregnancy and offspring ADHD was assessed in 6 studies with heterogeneity of 67%. Overall, a 17% increase in ADHD risk was reported following acetaminophen exposure when determined by physician diagnosis or psychometric test, with an odds ratio (OR) of 1.17.
When defining ADHD by physician diagnosis alone, the OR was 1.16, vs 1.15 for psychometric tests alone, highlighting no change in findings. Additional ORs included the following:
