Doctors in the UAE have urged caution over unsubstantiated claims by US President Donald Trump linking a widely used over-the-counter painkiller with autism.
Mr Trump advised pregnant women not to use paracetamol, known as Tylenol in the US, after asserting that it increases the risk of autism in children.
He said on Monday the US Food and Drug Administration would be updating guidance to doctors.
Paracetamol, chemically the same drug used in the UAE, is typically the go-to medication for use during pregnancy and while breast-feeding to treat mild to moderate pain.
The association with autism is contrary to medical research and consistent science that has proved the drug is safe to use during pregnancy.
Dr Meera Anto, a specialist gynaecologist at International Modern Hospital in Dubai, said women should not be misled into avoiding such pain-relieving drugs by Mr Trump's remarks.
“Though a few studies have shown a possible association between paracetamol use in pregnancy and autism, these studies have important limitations and do not prove causation," Dr Anto said.
"On the other hand, high fever in pregnancy is clearly harmful to both the mother and the baby, and paracetamol remains the safest antipyretic recommended in pregnancy when compared to NSAIDs [non-steroidal anti-inflammatory drugs], which have proven adverse effects.
"As with any medication, it should be taken in moderation and only when clinically indicated. However, statements such as the one made by Mr Trump should not mislead women into avoiding paracetamol when it is prescribed for genuine medical reasons."
Dr Waseem Dar, a specialist neurologist at RAK Hospital, said that while studies raising possible links to autism should be assessed, Mr Trump's comments did not take into account crucial gaps in research.
"Recent studies have suggested a possible link between paracetamol use in pregnancy and neurodevelopmental disorders such as autism in children," he said.
"However, these studies have important limitations. Many did not account for factors like fever or migraine during pregnancy, both of which themselves influence foetal brain development.
"All medicines should be used cautiously and judiciously during pregnancy, and this includes paracetamol as well," he added. "However, based on current evidence, increased incidence of neurodevelopmental disorders including autism can’t be linked to pre-natal paracetamol use, especially given the lack of robust meta-analyses."
The doctor stressed that a rise in autism cases can also be explained by "better healthcare services, improved physician training, broader diagnostic criteria and growing awareness among parents through social media and other platforms".
What is autism?
Autism Spectrum Disorder is a lifelong development disorder that affects communication skills and social interaction. Symptoms usually appear in early years and can affect learning, motor skills and attention span.
Causes are not yet fully understood, although scientists believe genetics play a part.
However, untreated pain and fever can cause problems for unborn children, doctors said.
There is no specific guidance in the UAE for taking paracetamol while pregnant. The Emirates Drug Establishment, the federal authority responsible for regulating all medical and pharmaceutical products in the UAE, has been contacted for comment.
In the UK, Dr Alison Cave, chief safety officer at the Medicines and Healthcare products Regulatory Agency (MHRA) said the advice could put unborn babies at risk.
“Patient safety is our top priority,” she said. “There is no evidence that taking paracetamol during pregnancy causes autism in children.
“Paracetamol remains the recommended pain relief option for pregnant women when used as directed.
"Pregnant women should continue to follow existing NHS guidance and speak to their healthcare professional if they have questions about any medication during pregnancy.
“Untreated pain and fever can pose risks to the unborn baby, so it is important to manage these symptoms with the recommended treatment.
“Our advice on medicines in pregnancy is based on rigorous assessment of the best available scientific evidence.
“Any new evidence that could affect our recommendations would be carefully evaluated by our independent scientific experts.
“We continuously monitor the safety of all medicines, including those used during pregnancy, through robust monitoring and surveillance.”
Untreated pain or fever during pregnancy can impair foetal development, and increase the risk of birth defects. Heart conditions, brain and spinal impairments can arise, with untreated pain also linked with premature births and miscarriage. Pregnant women who do not treat pain can also experience health problems such as high blood pressure, dehydration and depression.
The latest advice on acetaminophen was prompted by US Health Secretary Robert F Kennedy Jnr, who also supported a debunked theory that vaccines may be a cause of autism.
However, medical groups around the world continue to support the use of paracetamol during pregnancy, including trusted organisation the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
When should paracetamol be taken during pregnancy?
Paracetamol is recommended as the first-choice painkiller for pregnant women, used at the lowest dose and for the shortest duration. If pain is not resolved, patients are advised to seek advice from healthcare professionals.
What will change?
Nothing is likely to change. Drug safety is regularly reviewed by the Emirates Drug Establishment in accordance with any new scientific research to ensure the benefits to the patient and unborn baby outweigh any risks.
Should I stop taking paracetamol if pregnant?
No. According to medical advice, patients should not stop taking their pain medicine, because untreated pain and fever can pose risks to the unborn child. Women should consult their family doctor for further clarification.
