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In September 2025, US President Donald Trump claimed that paracetamol is a \u2018big factor\u2019 in autism, citing a systematic review based solely on observational studies. The review's selective reporting, methodological flaws (including applying an environmental health rather than evidence\u2010based medicine framework) and lack of causal evidence provided weak justifications for its conclusions and have fuelled public confusion about paracetamol safety in pregnancy. This article critically appraises the review and examines how scientific uncertainty can be manipulated and amplified within broader public health domains.<\/jats:p>","DOI":"10.5694\/mja2.70203","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T02:46:08Z","timestamp":1778813168000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paracetamol in Pregnancy: Uncertain Evidence, Certain Consequences"],"prefix":"10.5694","volume":"224","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3270-3475","authenticated-orcid":false,"given":"David J.","family":"Tunnicliffe","sequence":"first","affiliation":[{"name":"School of Public Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Centre for Kidney Research Children's Hospital at Westmead  Westmead New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6564-8615","authenticated-orcid":false,"given":"Miranda","family":"Cumpston","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventative Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6874-4506","authenticated-orcid":false,"given":"Debra","family":"Kennedy","sequence":"additional","affiliation":[{"name":"MotherSafe Royal Hospital for Women  Randwick New South Wales Australia"},{"name":"School of Women's and Children's Health University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margie","family":"Danchin","sequence":"additional","affiliation":[{"name":"Department of Paediatrics The University of Melbourne  Melbourne Victoria Australia"},{"name":"Vaccine Clinical Trials and Uptake Group Murdoch Children's Research Institute  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Teixeira\u2010Pinto","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Centre for Kidney Research Children's Hospital at Westmead  Westmead New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"J.Bhattacharya M.Makary andM.Oz \u201cThe Trump Administration's New Steps to Tackle Autism \u201dPolitico 2025 https:\/\/www.politico.com\/news\/magazine\/2025\/09\/22\/autism\u2010trump\u2010nih\u2010fda\u2010cms\u2010op\u2010ed\u201000575420."},{"key":"e_1_2_10_3_1","unstructured":"Australian Academy of Health & Medical Sciences \u201cAutism: An Evidence Brief \u201dAustralian Policy Observatory 2025 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