Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology

This review found a possible association between taking acetaminophen during pregnancy and an increased risk of neurodevelopmental disorders (NDDs) like ADHD and autism in children. However, the evidence comes mainly from observational studies, which can't prove cause-and-effect, and the review acknowledges limitations and potential residual confounding. While cautious acetaminophen use is advised, the authors emphasize the need to balance this with risks of untreated fever/pain and call for research into safer alternatives.

Dr. Baccarelli served as an expert witness for the plaintiff's legal team in related litigation. This involvement may be perceived as a conflict of interest, although he states efforts to maintain scientific integrity and objectivity.

This systematic review uses a robust methodology (Navigation Guide) and includes many relevant studies, suggesting an association between prenatal acetaminophen exposure and NDDs. However, it is limited by its reliance on observational data, which cannot definitively establish causality. Also, significant heterogeneity prevented meta-analysis, the existence of contradicting findings and sibling control analyses require cautious interpretation. Finally, the identified COI raises concerns.