Paracetamol in Pregnancy: Uncertain Evidence, Certain Consequences

David J Tunnicliffe; Miranda Cumpston; Debra Kennedy; Margie Danchin; Armando Teixeira-Pinto

doi:10.5694/mja2.70203

Paracetamol in Pregnancy: Uncertain Evidence, Certain Consequences

Med J Aust. 2026 May;224(5):e70203. doi: 10.5694/mja2.70203.

Authors

David J Tunnicliffe^{1

2}, Miranda Cumpston³, Debra Kennedy^{4

5}, Margie Danchin^{6

7}, Armando Teixeira-Pinto^{1

2}

Affiliations

¹ School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
² Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.
³ School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
⁴ MotherSafe Royal Hospital for Women, Randwick, New South Wales, Australia.
⁵ School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
⁶ Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁷ Vaccine Clinical Trials and Uptake Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Abstract

Autism diagnoses have increased over the past decade, prompting debate on potential causes. In September 2025, US President Donald Trump claimed that paracetamol is a 'big factor' in autism, citing a systematic review based solely on observational studies. The review's selective reporting, methodological flaws (including applying an environmental health rather than evidence-based medicine framework) and lack of causal evidence provided weak justifications for its conclusions and have fuelled public confusion about paracetamol safety in pregnancy. This article critically appraises the review and examines how scientific uncertainty can be manipulated and amplified within broader public health domains.

Keywords: epidemiology; guidelines as topic; health communication; pain; pregnancy; public health; systematic review.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Acetaminophen* / adverse effects
Analgesics, Non-Narcotic* / adverse effects
Autistic Disorder* / chemically induced
Autistic Disorder* / epidemiology
Evidence-Based Medicine
Female
Humans
Pregnancy
Pregnancy Complications* / drug therapy
Prenatal Exposure Delayed Effects* / chemically induced

Substances

Acetaminophen
Analgesics, Non-Narcotic

Grants and funding

APP1197337/National Health and Medical Research Council