Diagnoses of autism and ADHD have increased worldwide in recent years; these findings may affect future public health policies as well as clinical guidelines for pregnant women.
Diddier Giovanny Prada Ortega, a 2001 graduate of UIS with a doctorate in biomedical sciences from UNAM and postdoctoral studies at Harvard T. H. Chan School of Public Health, is part of the research team at the Icahn School of Medicine at Mount Sinai in New York, United States, which recently reported a possible link between prenatal exposure to acetaminophen and an increased risk of neurodevelopmental disorders, including autism spectrum disorder and attention deficit hyperactivity disorder (ADHD), in children. Their study, published in BMC Environmental Health, used the Navigation Guide methodology to systematically evaluate the scientific literature on this topic.
Acetaminophen, also known as paracetamol, is widely used during pregnancy to relieve pain and fever. The analysis, led by Mount Sinai, reviewed 46 studies with data from more than 100,000 participants in several countries. This research challenges previous assumptions about the safety of paracetamol during pregnancy and highlights the need for caution.
The systematic review methodology of the Navigation Guide provided a framework for assessing the risk of bias in each study and the overall strength of the evidence. According to Dr. Diddier Prada, professor at the Icahn School of Medicine at Mount Sinai, “our findings show that higher-quality studies are more likely to show an association between prenatal exposure to acetaminophen and an increased risk of autism and ADHD. Given the widespread use of this medication, even a small increase in risk could have important public health implications.”
Experimental models are quite robust in relation to the association and have demonstrated possible mechanisms. At the population level, all available evidence comes from observational studies, which are susceptible to bias. Given the ethical implications, most population studies determined exposure indirectly (questionnaires), so it is necessary to conduct prospective studies with the best possible design, including, for example, the quantification of acetaminophen in meconium to make the evidence even more robust,” the UIS graduate told the Communications Department.
The article analyzes the possible biological mechanisms that explain this association. Paracetamol can cross the placenta and contribute to oxidative stress, alter hormones, or cause epigenetic changes that affect fetal brain development.
Although this study has not established a causal relationship, its findings reinforce concerns about current clinical practices regarding the use of paracetamol during pregnancy. The researchers recommend cautious use under medical supervision, updated guidelines that better balance benefits and risks, and further research into safer alternatives for treating pain or fever in pregnant women.
Dr. Prada stated: “Pregnant women should not stop taking medication without consulting their doctor. Untreated pain or fever can also harm the baby. Our study highlights the importance of discussing the safest approach with healthcare professionals and considering non-pharmacological options whenever possible.”
The UIS graduate believes that access to high-quality public medical education, with world-class professors, served as his mentors in research and facilitated his first scientific publications, even as an undergraduate.
The full article on the study can be found at the following link: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-025-01208-0
