Acetaminophen in Pregnancy and Attention-Deficit and Hyperactivity Disorder and Autism Spectrum Disorder

( Obstet Gynecol . 2025;145:168-176. doi: 10.1097/AOG.0000000000005802.) Acetaminophen use during pregnancy is considered standard for pain relief and fever. Other treatments are available, but many do not have enough evidence for safety and effectiveness during pregnancy or have evidence showing increased risks of miscarriage or other adverse outcomes. An estimated 40% to 65% of women take acetaminophen during pregnancy, though estimates vary. Results of studies on acetaminophen use during pregnancy have been inconsistent, with some showing links to long-term reproductive tract or neurobehavioral outcomes and some showing no significant link. One area of major public interest is the association of acetaminophen use during pregnancy with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Though some studies have suggested links to these conditions, clinical recommendations have not changed, and there is much controversy surrounding the issue. This study is a clinical review of the pivotal epidemiologic studies that have evaluated the effects of maternal acetaminophen use during pregnancy and its association with ADHD and ASD.