There is no proof of the fact that the intake of paracetamol in pregnancy causes autism in the unborn child, nor are there drugs that can treat autism.
On Monday 22 September, the health leaders of the Trump government announced two initiatives related to autism. The first plans to update the indications on the illustrative leaflet of theAcetaminophenthe paracetamla that is commonly used in case of fever or pain, to say that its use in pregnancy involves the risk of autism and adhd in the unborn child.
The second is the approval of a drug already used in other areas, the leucovorinfor use in some children with autistic spectrum disorders. As highlighted, however, by many representatives of the medical community, neither proposals are based on scientific evidence. Let’s see why.
Autism and paracetamol in pregnancy: relationship, but not causal
“There are many studies that confuse a connection, but the most important was a Swedish study out of 2.4 million births (from 1995 to 2019), published in 2024, which used real data on the brothers and has not found any relationship between exposure to paracetamol in uterus and the subsequent development of autism, ADHD or intellectual disability” explains Monique Botha, associated professor of social psychology and the development of the university of social psychology Durham, United States.
“This suggests the absence of a causal effect of paracetamol on autism, evidence strengthened by the absence of a dose-dependent relationship. There is no solid evidence or convincing studies that suggest the existence of a causal relationship and any contrary conclusion is often motivated, sub-evidentity and not supported by the most solid methods to answer this question “.
The research of the Karolinska Institutet of Stockholm, Sweden and Drexel University of Philadelphia (United States) found a slightly increased risk of autism, in the children who had been exposed to paracetamol in uterus; But the effect initially connected to the drug disappeared, when these children compared with their brothers or sisters born from pregnancies in which the mother had never been treated with paracetamol.
When, that is, genetics was considered, the factor that most of all determines the risk of autism, it was seen that there was no connection between the use of paracetamol in pregnancy and neurosviluppo disorders. The study published on Jama It is considered the most rigorous ever accomplished by the unanimity of maternal and neonatal expert scientists.
What does it depend on then, the association found?
To tell the truth, several studies have detected the existence of an association between the intake of paracetamol in pregnant women and the prevalence of autism later in their children, but all are limited to finding a correlation, that is, a relationship between two variables (intake of paracetamol and autism) that tend to vary togetherbut without one cause of the other.
There are several reasons that could connect paracetamol and autism, without the drug being the cause: “The parents of autistic children could be more likely to take paracetamanla for reasons that include the fact that they are more likely to be autistic and that autistic people are more likely to have pain, that is, to be hypersensitive to pain or suffer from pains related to pain” says Steven Kapp, professor of psychology at psychology at psychology at psychology at psychology. The University of Portsmouth (England) and member of the coalition of autism scientists.
“Women with hypermability (a set of disorders characterized by the ability to extend some or all the joints beyond the normal physiological limits, editor’s note) are more likely to have autistic children (since the two conditions are connected) and therefore may have needed to take paracetamol for joint pain during pregnancy, but they are the shared genetic causes, and not the drug, that the child has more likely to be likely to be likely to be likely to be like Autist »adds Laurie Tomlinson, professor at the London School of Hygiene & Tropical Medicine.
Paracetamol: safe in pregnancy
All the main scientific agencies of reference (including the FDA, in a press release issued on the margins of Trump’s statements on September 22) reiterate that the paracetamol is safe in pregnancy, if used only when necessary and for the shortest possible time. High fever in pregnancy can in fact lead to the risk of pre-term birth and defects in the neural development of children.
Paracetamol remains the safest option available for women waiting, compared to anti -inflammatory municipalities such as aspirin and ibuprofen.
“The best evidence available tell us that the use of paracetamla in pregnancy is not related to autism. In the absence of new tests, the press release of the Trump Administration which instead states would seem an unfounded theory that will probably lead to denying pregnant women an essential treatment for fever and pain without a valid reason, in contrast with the US medical guidelines “explains Edward Mulins, associate professor of the George Institute for Global Health, at the Imperial College of London. In addition to causing the parents of children with autism with additional stress and senses of guilt unfounded in asking themselves whether their choices have played a role in the condition of their children.
No drugs “care” autism
The FDA has also announced the approval of a drug called Leucovorin available “on prescription, for children with autism”, even if, in an information sheet not mentioned in the press conference, it specified that the medicine will serve for the treatment not of autism in general but of the brain deficit of folate (CFD), a rare neurological condition that hinders the transport of the cooker (vitamin B9) to the brain) which can cause symptoms close to those of autism.
The drug is already used to mitigate the side effects of some chemotherapy that interfere with the metabolism of the folate and has been tested, in some small studies, in autistic children, with the aim of improving their verbal communication. In fact, some research suggests that part of the people with autistic spectrum disorders suffer from CFD, and some studies, none of whom are longer than six months, have suggested particular benefits of the medicine for a subgroup of patients in whom the CFD is present in autoimmune form.
“It could be possible that a subset of autism cases present this deficiency of folic acid, but I would be skeptical about any explanation or proposed treatment,” he said to Science Kristen Lyall, Drexel University epidemiologist.
There are also a large -scale studies on Leucovorin’s safety and optimal intake dosage. “While drugs can help with very specific aspects, there is no drug or treatment that actively or actively delete autism, although it can change the behavior or reduce the concomitant symptoms that contribute to the discomfort of autistic people” clarifies Monique Botha. “Autism is a permanent hereditary disability whose primary cause is extremely probable that it is genetic, expressed through a wide range of genes”.
