Acetaminophen and autism . . .

"Here are peer-reviewed papers, systematic reviews and mechanistic articles that have reported associations or argued biological plausibility for acetaminophen (paracetamol) exposure as a possible contributor to neurodevelopmental outcomes including autism." -- John H Abeles

Key studies & reviews that report an association or biological plausibility

Liew Z., et al., 2014 — “Acetaminophen Use During Pregnancy and Neurobehavioral Outcomes” (JAMA Pediatrics) — One of the large prospective cohort studies that reported associations between prenatal acetaminophen exposure and later ADHD-like behaviors; raised concern about potential neurodevelopmental effects.

Liew Z., et al., 2016 — “Maternal use of acetaminophen during pregnancy and risk of autism spectrum disorder in offspring” (Epidemiology / PubMed entry) — A population study that examined prenatal acetaminophen exposure and ASD risk and discussed confounding and methodological issues.

Bauer A., Kriebel D., 2016 (and related reviews) — “Prenatal and perinatal analgesic exposure and autism” (PubMed abstract / review) — Early review paper discussing the ecological correlation between rising paracetamol use and ASD, plus biologic plausibility and epidemiologic findings.

Robinson R. et al., 2016 / 2017 — “Acetaminophen Use in Early Life and Autism” (systematic and mechanistic reviews) — Reviews that summarize observational studies linking early-life acetaminophen (not only prenatal exposure) to increased ASD risk and discuss mechanisms (oxidative stress, immune effects). Example review available on PMC.

Mega-cohort / consortium analyses (2021) — “Prenatal and postnatal exposure to acetaminophen in relation to neurodevelopmental outcomes” (European cohorts) — Large pooled analysis of multiple cohorts (≈73,000 pairs) investigating prenatal and early postnatal acetaminophen exposure and ASC/ADHD outcomes; results were mixed and interpreted as inconclusive but included signals worthy of further study.

Systematic review (2022) — “A Systematic Review of the Link Between Autism Spectrum Disorder and Acetaminophen” (PMC review) — Comprehensive systematic review summarizing observational studies, heterogeneity across results, and limitations (confounding, exposure measurement).

Prada D. et al., 2025 — “Evaluation of the evidence on acetaminophen use and neurodevelopmental outcomes” (open-access review) — A recent evidence evaluation that concluded many studies report associations between prenatal acetaminophen and NDDs (ASD/ADHD) but stressed heterogeneity and residual confounding.

Mechanistic papers (oxidative stress / mitochondrial hypotheses) — Articles that discuss plausible biological mechanisms (oxidative stress, mitochondrial dysfunction, immune/inflammatory pathways) by which ac