JAMA Pediatr
Large Danish study finds no link between autism and prenatal acetaminophen use
Clinical Takeaway: Reassure pregnant patients that acetaminophen, used as indicated, was not associated with increased autism risk in a large, well-controlled population study.
Acetaminophen is the most commonly used analgesic in pregnancy, and safety concerns have led some patients to avoid treating fever or pain, both of which carry known maternal and fetal risks.
In a nationwide Danish cohort study, prenatal exposure to acetaminophen wasn’t associated with an increased risk of autism spectrum disorder (ASD) in offspring.
Investigators analyzed health registry data from more than 1.5 million singleton children born between 1997 and 2022. About 2% were exposed to acetaminophen in utero, based on filled maternal prescriptions. Autism was diagnosed in 1.8% of exposed children compared with 3.0% of unexposed children. After adjustment for maternal, pregnancy, and sociodemographic factors, acetaminophen exposure during pregnancy wasn’t associated with autism risk (hazard ratio ~1.0), with similar null findings across trimesters, dose categories, and in sibling-comparison analyses.
“Overall, our findings showed no association between the use of acetaminophen during pregnancy and risk of autism in offspring,” said lead author Kira Philipsen Prahm, MD, PhD, noting that the study was designed to address public concern raised by prior conflicting reports.
The authors conclude that previously reported associations may reflect residual confounding rather than a causal effect and that acetaminophen remains an appropriate option for pain and fever management during pregnancy when used judiciously.
Source: Prahm KP, et al. (2026, April 13). JAMA Pediatr. Acetaminophen Exposure During Pregnancy and the Risk of Autism in Offspring