Acetaminophen, or paracetamol, is one of the few safe painkillers for pregnant women. It is commonly used to treat fever and pain during pregnancy. Yet a new study has started a controversy regarding whether it might have unintended consequences on the brain development of a baby.

What did the new study find?

A recent study in the United States looked at 307 Black women who took acetaminophen during pregnancy. Researchers determined that children of these mothers were three times as likely to have Attention Deficit Hyperactivity Disorder (ADHD) diagnosed in them. The risk was higher for daughters as well—greater than six times.

Although this may sound alarming, specialists state that this is a small study, and the findings are not conclusive. Acetaminophen is what most pregnant women use, and untreated fever or pain may also hurt the baby. Scientists are in agreement that more studies need to be conducted before any medical recommendations are changed.

Dr. Sheela Sathyanarayana, a UW Medicine pediatrician, states that acetaminophen was approved for use decades ago but its long-term consequences for babies were never extensively studied.

"This medication was… approved decades ago, and may need reevaluation by the FDA," she says.

In earlier research, some scientists established a connection between the use of acetaminophen during pregnancy and ADHD as well as autism in children. However, other research did not establish any connection, which complicated the debate even further.

What do experts say?

health organizations, such as the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the American College of Obstetricians and Gynecologists (ACOG), continue to state that acetaminophen is safe when taken in the lowest dose for the shortest duration.

Dr. Viktor Ahlqvist, a Swedish geneticist at the Karolinska Institute, notes that the new research did not take into account why mothers used the medicine. Headaches, infections, or fevers—conditions that can also impact child development—were not factored in.

What should pregnant women do?

In 2021, 91 scientists and physicians called for caution, advising pregnant women:

Take acetaminophen only when medically necessary.

Consult a doctor or pharmacist before taking it regularly.

Take the lowest dose for the shortest amount of time needed.

But ACOG differs and states we don't have to alter medical recommendations until stronger, larger studies are done.

The FDA reviewed this in 2015 and determined that there is no strong evidence acetaminophen leads to ADHD or autism. New research gives cause for concern, but we need more and better studies, experts say.

For the meantime, pregnant women need to talk with their physicians and weigh the pros and cons of taking acetaminophen.

The study was published in Nature Mental Health

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