In particular, the U.S. administration cited a study published last summer which found a link between paracetamol during pregnancy and increased incidence of neuro-developmental disorders (NDDs). But in this review “there are several studies [which] suffer or are vulnerable to bias,” Khalil said. “The potential implications of not accounting for these confounders is that you draw their own conclusions.”
The Lancet’s evidence review instead focused on studies with the most rigorous research methods, such as those at low risk of bias, those with sibling comparisons and with at least five years of follow up — and found no link.
In particular, sibling-comparison studies allow researchers to compare children born to the same mother, who only took paracetamol during one of the pregnancies. They take into account shared genetic factors, shared family and long-term parental characteristics.
“Our findings suggest that previously reported links are likely to be explained by genetic predisposition or other maternal factors such as fever or underlying pain, rather than a direct effect of the paracetamol itself,” Khalil said.
Public health experts, the EMA and the European Commission, pushed back against Trump’s position last year, arguing there was no evidence to support it.
“While the impact of last year’s announcement has been extensive, I hope the findings of this study bring the matter to a close,” Grainne McAlonan, professor of translational neuroscience at King’s College London, said.
“Expectant mothers do not need the stress of questioning whether medicine most commonly used for a headache could have far reaching effects on their child’s health,” McAlonan said.