The American government has raised concerns about the pain relievers used during pregnancy
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On Monday, the US government announced two initiatives related to autism. It will update labeling on common analgesic paracetamol, also called acetaminophen, use of warning during pregnancy can increase the risk of autism and ADHD in children. He will also approve a drug called Leucovorine for use in some children with autism spectrum disorder (ASD). None of these movements is based on robust scientific results, and they probably have a minimal effect on autism rates in the United States.
The announcement comes after the highest public health official in the country, Robert F Kennedy Jr, undertook in April to identify the causes of autism at the end of September. President Donald Trump presented initiatives as “historical stages to face the autism crisis” during a press conference.
This framing reveals either a misunderstanding or a false declaration of what we know about autism. There is no crisis – autism rates began to increase rapidly in the 1980s as diagnostic criteria for the disease have extended. In recent decades, a higher level of awareness and recognition of autism symptoms has also contributed to an increase in autism diagnoses.
As for the cause of the condition, there is little evidence suggesting that paracetamol is to be blamed. It is true that multiple studies have suggested that using paracetamol during pregnancy can increase the risk of autism in children. A recent analysis of 46 studies revealed that 27 of them identified a significant association between the use of paracetamol during pregnancy and children with a higher risk of neurodevelopmental conditions such as autism. But it is not because there is a relationship that paracetamol causes autism – other factors could be at stake.
And there are contradictory results of other studies. For example, a study in 2024 of nearly 2.5 million children found a slightly higher risk of autism in people exposed to paracetamol during pregnancy, but after comparing children exposed to analgesics with those of their unpresenting brothers and sisters, the effect has disappeared. “It is the family story that counted and not the use of paracetamol,” said Dimitrios Siassakos at the University College of London in a press release. “Research has shown that any apparent marginal increase [in autism] Due to paracetamol during pregnancy, it tends to disappear when analyzes take into account the factors that matter the most, “like genetics, which decades of research have indicated is a principal contributor to the condition.
During the press conference, Trump said pregnant women should not take a paracetamol for pain or fever during pregnancy unless they can “do not finish it”, and “they should speak to their doctors for more information”. However, the Food and Drug Administration of the United States (FDA) recognized in a press release, a causal relationship between paracetamol and autism has not been established and said that in an opinion to paracetamol doctors remains the most surely available pain reliever for use during pregnancy. “”[It] is the only over -the -counter medication approved for use to treat fevers during pregnancy, and high fevers in pregnant women may have a risk for their children, “said the agency. Fever during pregnancy has been linked to birth and prior defects in the development of the brain or spinal cord in the fetus.
The FDA has also announced that it would approve the drug Leucovorine for people with a brain folate deficiency, a condition that alters the absorption of vitamin B9 in the brain. Some research indicates more than 40% of autistic people can also have this condition, which results in similar symptoms, including communication and sensory treatment problems.
Leucuvorine, a form of vitamin B9, is already available to treat the deficiencies of this vitamin as well as for the side effects of certain cancer drugs. The first evidence suggests that this could also improve certain symptoms of serious autism. For example, a 2016 study dealt with 23 autistic children suffering from language disorders using two doses of leucuvorine daily while a group separate from 25 children received a placebo. After 12 weeks, 65% of children receiving leucuvorine experienced clinically significant improvement in verbal communication compared to 24% of those in the control group.
But so far, all studies on leucuvorine and autism have been small and only indicate modest improvements. A larger clinical trial is in progress, the results of which are expected next year. “Any proof available at this stage is exceptionally provisional and would not be considered robust,” said Monique Botha at the University of Durham in the United Kingdom in a press release. “While drugs can help very specific aspects [of autism]There is no medication or treatment that heals or actively erases autism. »»
Following the announcement, the American Ministry of Health and Social Services said in a statement that “although promising, it is important to note that Leucovorine is not a remedy for TSA and can only lead to improvements in the words related to speech for a subset of children with ASD”.
Kennedy, with the support of Trump, made the fight against the “autism epidemic” a pillar of American public health policy. They both described these policy changes as remarkable progress made in a short time. But science does not suggest avoiding paracetamol during pregnancy or taking leucuvorine will considerably affect autism as Trump and Kennedy said. Instead, the most likely result of these initiatives is that they will sow confusion around how and the moment of treating pain or fever safely during pregnancy.
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