Trump raises spectre of previous autism misinformation

Associate Professor John Kramer hopes the latest health story from the US will fade quickly away from the news cycle – but fears the opposite will happen.
 
The Chair of RACGP Specific Interests ADHD, ASD and Neurodiversity is expecting GPs in Australia to notice an impact from yesterday’s announcement from President Donald Trump linking paracetamol use in pregnancy to autism in children.
 
‘It will have an effect, unfortunately,’ he told newsGP.
 
‘It’s going to confuse people. I see it as an example of Trump’s general behaviour in creating a media storm about any number of issues as a distraction from other issues.
 
‘It’s essentially a smokescreen to distract the populace… but it’s a dangerous one because it’s going to unnecessarily scare a lot of parents with kids.
 
‘Autism is felt to be predominantly genetic, but there are environmental factors as well – just how much of each is a bit uncertain.
 
‘But the study that Trump is trumpeting here is based on poor science and disagrees with a recent, much larger study out of Sweden.’
 
The White House cited several studies that raised a potential association between exposure to paracetamol during pregnancy and an increased chance for the offspring to be diagnosed with ASD or ADHD.
 
However, none gives a causal link, and a succession of health organisations have dismissed the claim as ‘baseless’.
 
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) was among the many voices raising serious concerns about the scientific basis used by the White House.
 
They also referenced the same study as Associate Professor Kramer, which was published in JAMA last year, in a statement released on Tuesday.
 
‘The earlier studies showed an association between paracetamol exposure and these diagnoses but were importantly limited by a methodological inability to differentiate between the effect of paracetamol as a causative exposure as opposed to a statistical association,’ they said.
 
‘The most recent and robust study to evaluate this association was published in 2024 by Ahlqvist et al. 
 
‘This study of 2.5 million Swedish children found that, when controlling for important factors including parental neurodivergent diagnoses and sibling relationships, there was no association between paracetamol exposure and offspring neurodivergence.’
 
For Associate Professor Kramer, the way GPs handle patient inquiries that result will depend on the existing patient-doctor relationship.
 
‘Somebody that the GP already knows well will probably be quite happy with being told, “Look, there’s no evidence for this. If there was, we would have acted on this a long time ago,”’ he said.
 
‘But if people want to see more evidence refuting the postulation from Trump, then the evidence is there too.’
 
He said that some patients may hark back to claims made by the British clinician Andrew Wakefield, whose study linking the combined measles, mumps and rubella vaccine to autism was published in The Lancet in 1998 – and then completely debunked several years later.
 
‘It’s always good to remind them about how that all started and what the end result was and how the results were fabricated to produce an outcome that was never demonstrated,’ he said.
 
RACGP Vice-President and WA Chair Dr Ramya Raman, also feels the announcements made in the White House are likely to have an impact in GP consulting rooms in Australia – and worries it will cause ‘unnecessary alarm’.


A study of 2.5 million Swedish children found no association between paracetamol exposure and offspring neurodivergence.

‘It’s too early to tell whether GPs are noticing an increase in questions from women concerning the use of paracetamol during pregnancy,’ she said.
 
‘However, given how much attention this announcement is receiving I wouldn’t be surprised if many patients raise this issue with their GP in the days, weeks, and months ahead.
 
‘The key point for all of us to remember is that any small associations in this area must be weighed against the risk of untreated high fever in pregnancy for the mother and developing baby.
 
‘This is vital, because untreated fever in pregnant women is also a risk factor for various adverse outcomes including miscarriage and birth defects.’
 
‘As a practising GP who cares for patients with autism spectrum disorder [ASD], I have to say that this type of discussion about ASD causation is unhelpful.
 
‘The best source of advice and guidance is a regular GP who knows you and your history, and I urge Australian families, including pregnant women and those with children diagnosed with ASD, to have that front of mind.’
 
Associate Professor Kramer, meanwhile, is not overly optimistic about the chances of reducing the impact of the story in Australia.
 
‘I’d like to think that it is not going to trouble too many people, but I’ve learned never to overestimate the health literacy of the Australian community,’ he said.
 
‘People will hear something they might think in their rational moments, “no, that can’t be true”.

‘But people aren’t always rational thinkers, and it’s just going to sow a seed of doubt, induce anxiety without any basis and it’s just a destructive move.
 
‘It demonstrates to me what happens when you sack the health experts from the [US Centers for Disease Control and Prevention] and replace them with untrained, unexperienced loyalists who play the party line.’
 
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ADHD ASD and Neurodiversity autism Donald Trump health misinformation pregnancy vaccination