Paracetamol In Pregnancy: Is There A Risk?

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2:44Paracetamol in pregnancy, here's the unprocessed truth. Last week on September 22nd, President Trump and Robert F. Kennedy Jr. announced that new evidence shows that Tylenol, or paracetamol as we call it in the UK, and its use in pregnancy may raise autism risk. And within hours, the BBC headline read, Trump makes unproven link between autism and Tylenol. And here's where the problems start and where we need to understand the truth, not just the media headlines. So let's go back to the beginning of this story. Why is this important and why is this a scientific debate and conversation we need to have?

3:25Well, autism diagnoses have risen so sharply, they were once one in 10 ,000. Now they're closer to one in 31 children in the United States. But in California, it's one in 19. And if you look at boys specifically, about one in 12 boys born today in California will have autism. So they are scary numbers. They point to something going on that we need to investigate. Even if much of the increase reflects broader definitions of autism, better diagnoses of autism. We need to ask some questions because at this scale, we've got to think that there's some environmental exposures that could be part of this picture.

4:20It's not just bad luck. We need to examine all possible contributors. So let's get into what happened last week. According to the BBC and the media in general, Trump makes unproven claims. Big hoo-ha, big problem. Everyone starts to Trump bash and say, Trump, Trump, Trump, he's an idiot, he's an idiot. Now, he may be, and you may be able to think that, but actually what him and RFK Jr. were quoting was a Harvard study. Andrea Baccarelli, the dean of the faculty at Harvard, T.H. Chan School of Public Health. It wasn't Trump. It wasn't RFK. It was Harvard. John Hopkins, one of the world leading medical establishments, also found a 3.62 times increased risk with high Tylenol use during pregnancy for increased neurological development disorders.

5:25So this isn't Trump. This is well-respected, well-regarded medical institutions. So what did our UK Health Secretary Wes Street have to say? I trust doctors over President Trump, frankly, on this, quoting him directly. So you've got politicization of medicine, of science. So we need to look beyond the headlines and understand really what's going on. So let's go back to that Harvard systematic review that looked in 2025 at 46 studies of paracetamol and pregnancy intake and autism. So if there's no evidence and there is an unproven link, you might think that, well, 46 studies should show nothing.

6:19But the actual truth is that 27 of those 46 studies reported a positive association between prenatal paracetamol and neurodevelopment disorders. Nine of the studies were null and 24 even suggested protective effects. That's why we do systematic reviews. Science is difficult, it's complicated. There can be lots of factors that affect it. So systematic reviews and meta-analyses of multiple studies is a really good way to get an understanding of what's going on. And more than half, 27 out of 46, showed there was an association. Now, association does not equal causation. they're not the same thing but the sheer volume indicates something is worth investigating.

7:09Now I quickly did a search on the Consensus app which is an AI tool that allows you to search thousands and thousands of scientific studies in journals to understand what's going on in a particular topic and I did a pro search which can only slim it down to around 20 studies but it reviews a thousand and then breaks down the best evidence. And so according to Consensus App, when I say does paracetamol use in pregnancy or early childhood increase risk of autism in children, the data is fairly similar. We get eight studies back or 47 % that said, yes, there's a link. five that say possibly, well, that's 29%.

7:55One that's totally mixed, which is 6%. And three that say no, that's 18%. Now, Contensys app has its own problems. It's only showed me 17 studies there. It's got thousands on its database, but I have to pay for a pro license, which I didn't do to go deeper where you can get over 50 studies. Now, why are people up in arms and going, association doesn't equal causation. We live in a culture obsessed with dieting, weight loss, and exercise. And that can make eating disorder behaviors easy to miss. But the reality is, eating disorders are serious mental illnesses that take a major toll on your health and your life.

8:40But recovery is possible. Eating disorders are more common than you might think. Chances are you know someone who is struggling with one. Or maybe you're struggling yourself. If you're concerned about an eating disorder in yourself or a loved one, I want to introduce you to Equip. Equip is a fully virtual, evidence-based eating disorder treatment program that helps patients achieve lasting recovery at home. Every Equip patient is matched with a multidisciplinary care team that includes a therapist, dietician, medical provider, and mentors. And you get a personalized treatment plan that's tailored to your unique goals and challenges.

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9:52Stick with your wellness goals. Go to kachava.com and use code SMOOTHY for 15 % off. That's K-A-C-H-A-V-A dot com, code SMOOTHY. Well, there was a Swedish sibling study published in JAMA 2024. Stress tested the associations. And in standard analysis, tiny risks did appear to be linked between paracetamol use and neurological development disorders. But when researchers compared siblings in the same family, the links to autism, ADHD, disappeared. That strongly suggests that observed associations may be explained by confounding factors like genetics or family environment or underlying reasons the medicine was taken in the first place.

10:43such as fever, because fever in itself can increase risks during pregnancy. So some paracetamol use to bring down a fever may well be a very smart move, but we don't know. So here's the thing, both can be true. The review is right. Many observational studies report a signal that there is a risk between paracetamol use during pregnancy and autism or neurological issues. But the sibling study is also right, that those signals may be artifacts of confounding factors. So the real truth is, we don't fully know. The science is an ongoing debate. It's built on testing, retesting, and arguing over the evidence until patterns become 100 % clear.

11:32And that process is still unfolding on this particular topic. Now, here's the problem. The media creates division, it creates misunderstanding, and it doesn't report the truth. Because the BBC framing this as an unproven link, while technically accurate, was not a neutral reporting. The reporting goes on to conclusively state there is no evidence that paracetamol causes autism. Yet if 27 out of the 46 studies report an association, that is evidence, may not be the gold standard evidence, it may not be all the evidence we need, but it is evidence. So to say there is no evidence, most people just read the headline.

12:26So that's misleading and it dismisses the concern outright when there's something people need to know here. These headlines sway public opinion and they prime people to believe there's nothing there. So it's a bit of a problem because the science is not declaring final truths. It's having the debate in public questioning and openly testing competing ideas. So to say the link is unproven without acknowledging the link is being actively investigated undermines the scientific process because politicians are turning this into a fight. We hate Trump versus we don't hate Trump. And the media is fueling that and making extreme headlines that gets clicks.

13:12But unfortunately, the public lose the ability to review and weigh the data for themselves without being biased. So let's get into the practical takeaways and summarize this because it's very complicated. Regulators and medical colleges are consistent. Paracetamol remains the first choice for pain and fever relief during pregnancy. It's the best option we have. And in cases of fever may be a better option than not taking anything at all to bring down that fever if you have a really high fever, because fevers in pregnancy can also be dangerous in themselves. So we should use paracetamol in pregnancy, but only when needed in the lowest effective dose for the shortest possible time.

14:04And now, if you look beyond all the headlines, actually what Trump and the US Food and Drug Administration, the FDA, did is they simply said the doctors should consider limiting the use of paracetamol while also taking into account that it's the safest over counter option to treat fever and pain in pregnant women. So what are they actually doing? They're putting a warning on the label that if you're pregnant, you should consider maybe not using paracetamol unless absolutely necessary, because there is an association here that I wouldn't want to take, I wouldn't want my wife to take that risk on an unborn child.

14:49If, you know, it's just a headache, you can get on with your day, maybe take an electrolyte that might actually help prevent that headache rather than a paracetamol that just covers it up, right? There are other ways to approach these things. If they're simply, you're feeling uncomfortable, you don't need to pop paracetamol. That's where Trump, you know said maybe it shouldn't be used as frequently as everybody does today and we should err on the side of caution and minimize the use unless clearly necessary that is a valid and wise choice and a great bit of advice for pregnant women so the bottom line yes over half of studies in one review reported an association yes autism rates are climbing and it's right to ask the questions but no extremes in politics or the media should not be helping parents make their choices the science should be and reading the science there is a choice the science is currently unsettled the debate is ongoing but parents deserve the facts and the balance not the headlines so you should be making your own choice because politicians claim certainty and the media dismisses it as unproven in the same breath they rob you of the chance to hear the full story hear the science and make up your own mind for your body and your potentially unborn baby at the end of the day that's how I look at it if you'd rather avoid any potential risk it may be worth skipping paracetamol, unless absolutely necessary, of course, in a case of extreme high fever.

16:35But, you know, if you have taken it, don't worry, the chances are very low. And if you are going to take it for fever, again, don't worry, because untreated illnesses like fever could also be dangerous. So both positions are reasonable and accurate, according to where we are with the science today. But the science is still debated. And until we know more, it's about you making a choice for your body. It's about you balancing the risks, listening to your body and making the decision that feels right for you. Not listening to Trump, not listening to West Street, not listening to the BBC or the media.

17:13Understanding the data and the science and making the choice for you. And that's the unprocessed truth.

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