SynthesisBMJ (Clinical research ed.)2025
Maternal paracetamol (acetaminophen) use during pregnancy and risk of autism spectrum disorder and attention deficit/hyperactivity disorder in offspring: umbrella review of systematic reviews.
Synthesis in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed.
- Article
- Paracetamol: A History of Assumptions, Errors, and Evidence Reversals in Pain Management.Current pain and headache reports · 2026Review
- Neuroinflammatory Response to Postnatal Administration of Valproic Acid in Wistar Rats as a Mechanism for the Development of Autism Spectrum Disorders: The Role of Neutrophils.Brain sciences · 2026Article
- Toxicologic Pathology Forum Opinion*: In Defense of Scientific Freedom.Toxicologic pathology · 2026Article
- A comprehensive overview of the biological foundations of ADHD.Bioscience reports · 2026Review
- The Prenatal Dilemma: Fever vs Acetaminophen? Navigating a Difficult Choice.ACS pharmacology & translational science · 2026Article
- Beyond the Headlines: Examining the Evidence Around Acetaminophen and Autism Risk.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026Article
- Acetaminophen in pregnancy.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Paracetamol in Pregnancy: Uncertain Evidence, Certain Consequences.The Medical journal of Australia · 2026Article
- 'Staggering' number of people believe unproven claims about vaccines, raw milk and more.Nature · 2026Article
- A Noisy Signal? Geographic Bias in FAERS Reports Linking Paracetamol to Autism Spectrum Disorder.Journal of clinical medicine · 2026Article
- Is paracetamol in pregnancy a risk factor for ADHD?Nature · 2026Article
- Prevalence and predictors of analgesic use during early pregnancy in a Brazilian population.Frontiers in pharmacology · 2026Article
- Efficacy and Safety of Paracetamol and NSAIDs for Fever and Pain Management in Children with Chronic Diseases: A Narrative Review.Children (Basel, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the quality, biases, and validity of evidence on maternal paracetamol (acetaminophen) use during pregnancy and the risk of autism spectrum disorder (referred to as autism) and attention deficit/hyperactivity disorder (ADHD) in offspring.
designUmbrella review of systematic reviews. DATA SOURCES: Medline, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews, along with grey literature, Epistemonikos, and the reference lists of included studies (inception to 30 September 2025). INCLUSION CRITERIA: Systematic reviews of randomised trials and cohort, case-control, or cross sectional studies that reported maternal paracetamol use during pregnancy and the diagnosis of autism or ADHD in offspring. Details of the primary studies included in the reviews are reported, including adjustments for key confounders (maternal characteristics, indication for paracetamol use, and familial factors) and unmeasured confounders and ascertainment of outcomes.
resultsNine reviews (40 studies) reporting on autism (six studies) and ADHD (17 studies) in offspring were included. Four reviews undertook meta-analysis. The overlap of primary studies included in the reviews was very high (corrected covered area 23%). The reviews reported a possible to strong association between maternal paracetamol intake and autism or ADHD or both in offspring. Seven of the nine reviews advised caution when interpreting the findings owing to the potential risk of bias and confounding in the included studies. Confidence in the findings of the reviews was low (two reviews) to critically low (seven reviews) based on the AMSTAR 2 (A MeaSurement Tool to Assess Systematic Reviews) criteria. Only one review included studies (n=2) reporting autism and ADHD in offspring that appropriately adjusted for familial factors and unmeasured confounding through sibling controlled analyses. In both studies, the increased risk of autism in offspring (one study, hazard ratio 1.05, 95% confidence interval 1.02 to 1.08) and ADHD (two studies, 1.07, 1.05 to 1.10 and 2.02, 1.17 to 3.25 ) observed in the whole cohort analyses did not persist in sibling controlled analyses for autism (0.98, 0.93 to 1.04) and ADHD (0.98, 0.94 to 1.02 and 1.06, 0.51 to 2.05).
conclusionExisting evidence does not clearly link maternal paracetamol use during pregnancy with autism or ADHD in offspring. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420251154052.
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