Does Paracetamol Use in Pregnancy Cause Autism? Here’s What the Evidence Says

What are the causes of autism?

Autism does not have a singular cause. The available scientific evidence suggests that autism arises from a combination of genetic and environmental factors.

Some people are born with genetic changes that make them more likely to have autism. These can be passed down from parents to children, or they can occur naturally as the baby grows. These changes in the genes do not guarantee an autism diagnosis in a child, but they can increase the likelihood. 

There are also certain factors surrounding pregnancy and birth that can contribute to the development of autism. These include if the baby is born prematurely, has a low birth weight, is exposed to air pollutants or certain heavy metals before or during pregnancy, is born to parents of increased age, has severe complications at birth, or if the mother has health problems like diabetes or infections while she is pregnant. 

It is important to remember that none of these factors operates independently. Most children born in these conditions will not go on to be diagnosed with autism. Autism occurs when several of these factors interact in complex ways that we do not yet fully understand. 

Is autism on the rise?

We are seeing more diagnoses, but that does not mean there are more cases of autism. The rise in autism diagnoses is due to increased awareness, more inclusive definitions, and better access to assessments. It is not because there are suddenly more people with autism.

A few numbers:

The Centres for Disease Control and Prevention now say that about 1 in 31 eight-year-olds in the United States have autism, compared to 1 in 150 in 2000.

The World Health Organisation says that about 1 in 127 people around the world has autism. UK data suggests that 1 in 100 children and adults has autism.

A large study focused on UK data found that the number of recorded autism diagnoses went up by almost eight times between 1998 and 2018. This indicates a greater recognition of groups such as girls, women, and individuals with milder forms of autism than previously.

I have certainly noticed an exponential increase in the number of both children and adults who are seeking a referral for an autism assessment, which I attribute to the rise in the number of people being diagnosed, but that is mostly because we are getting better as a society at identifying autism.

Trump claimed a link between paracetamol use in pregnancy and autism. Is there any scientific truth to it?

 As a doctor and a mother who recently had to take my son through the autism assessment process, my initial reaction was deep concern. When you are worried that your child is not developing as expected, you are likely already concerned about what this means for their future, how they will perform in school, and whether they will be able to live independently later in life. It is a long, stressful, and emotional journey. It is not fair or right to blame something as common as taking paracetamol as the cause of autism on top of everything else. Parents who are undergoing the assessment process or caring for a child with autism already face numerous challenges; they don't need the additional burden of guilt about how their actions may have contributed to it, especially when based on unfounded claims.

In my case, I did not take paracetamol while I was pregnant, but we still had to go through this pathway. That alone demonstrates the danger and inaccuracy of making broad claims. 

Let us focus on the science. Some research has suggested a potential association between paracetamol consumption during pregnancy and subsequent diagnoses of autism or ADHD. However, the evidence is inconsistent and full of limitations.

A large Swedish study with more than 2 million children found that the link between paracetamol use and autism virtually disappeared when they took into account factors such as genetics and the environment. It is also important to remember that pregnant women and birthing people who need paracetamol during pregnancy may be unwell with a fever or an infection, both of which are risk factors in themselves for autism.

The Medicines and Healthcare products Regulatory Agency has reviewed the evidence and released a statement on the 23^rd September, concluding that the use of paracetamol during pregnancy as a pain reliever and medication to treat fevers remains safe and that there is no evidence that taking paracetamol during pregnancy causes autism in children

Why is Trump talking about autism now?

Autism affects many families and brings up strong emotions. We all know someone in our immediate family or friendship network who has received a diagnosis of autism and have seen how it can affect families. Linking it to something as common as paracetamol guarantees headlines. It creates the illusion of a simple answer to a highly complex condition, which we still do not fully understand.

It also contributes to a broader narrative of distrust in medicines and the medical establishment, which some politicians exploit to garner support. It is also being used as a distraction technique from recent policy changes defunding women’s health access and research. Autism has sadly been used in this way before, most notably in myths about vaccines, and history seems to be repeating itself.

Who are the real victims of Trump's claims?

There are many reasons why these claims are dangerous. First, they might make pregnant women stay away from paracetamol even when it is the safest way to treat pain or fever. For instance, a fever that isn't treated can be much worse for both the mother and the baby than the medicine. It may also deter pregnant women and birthing people from seeking medical attention, which can have serious consequences due to delays in care or result in them taking other medications that are unsafe during pregnancy.

Second, they support the harmful idea that mothers are to blame for autism. Saying otherwise makes parents feel more ashamed and guilty, and this could lead to an avoidance of seeking help for their child if autism is suspected, as they fear they will be blamed.

Third, these kinds of claims divert attention away from genuine scientific research. We need to invest in better resources to support children with autism and their families, as well as develop improved pathways to ensure an earlier diagnosis, rather than focusing on finding someone to blame. Early intervention leads to better outcomes.

Lastly, these types of discussions make people less likely to trust health advice when they need it most. Therefore, who suffers? Pregnant women, children with autism and their families, and the general public's health will bear the brunt of this impact. The collateral damage is trust in the healthcare system, which once broken is very difficult to restore.

Is there a potential benefit? How Trump’s claims could unintentionally draw attention to autism

The only possible silver lining that could emerge from his statement is that people are discussing autism, which could lead to more research. We need to learn more about how pregnancy health and medications may or may not affect the growth of a child.

But attention is only beneficial if the information shared is accurate. Sensational claims can do more harm than good by making people scared and ashamed. 

Families need help, not blame. Autism is not a disease; it is a neurodevelopmental difference. It affects everyone differently, which is why it is referred to as a spectrum disorder, and the level of need and support varies from individual to individual. It demonstrates the diverse ways that the human brain functions. As someone with dyslexia myself, I know that once the right support was in place, what was once considered a struggle became my superpower. Dyslexia has helped me think more creatively, develop innovative solutions to problems, and ultimately thrive in my career. People should think of autism the same way.

Our focus should not be on searching for someone or something to blame but on creating the right pathways so that children with autism and their families get early diagnosis and the support they need to thrive. Autism deserves understanding, not headlines built on fearmongering, and every child deserves the chance to be provided with the resources, tools, and support needed to discover their own superpower.