You're listening to a MoMA Mea podcast.

Hi there, it's Claire Murphy here.

Hope I Drip into the Perimnisphere is giving you a bunch of stuff to think about and take to your own GP.

Now, you might have heard some news this week about Donald Trump and his Health Secretary Robert F.

Kennedy Jr.

Telling you that taking paracetamol during pregnancy causes autism.

Here's a spoiler alert for you.

It doesn't.

We investigated this on Muma MEA's daily news podcast, The Quickie, with senior Lecturer in Maternal Fetal Medicine at the University of Western Australia, doctor Scott White.

So if you're worried about it, this will make you feel a whole lot better.

Effective immediately, the FDA will be notifying physicians at the use of asset menefen acetamenofin, which is basically commonly known as taylan ol during pregnancy, can be associated with a very increased risk of autism.

So take into ellanol is not good.

That was a message from US President Donald Trump yesterday as he announced a link between increasing rates of diagnosed autism in the US to the use of the drug tylanol by pregnant women.

It's commonly used to relieve pain and fever.

The drug which you'll hear being called a set of minif in its generic name, we call here in Australia paracetamol, the most commonly taken painkiller in the world.

Trump suggested women who are dealing with a fever simply tough it out, and if they can't, maybe you will have to get tylanol, but only in the case of extremely high fever, and only if you can't tough it out.

The head of the US Health Department, RFK Junior, had promised to reveal the cause of autism before September, as well as what can be done to cure it.

The answer to that, they said, is another drug called luc of orn a folinic acid.

So what does the science actually say.

Medical experts have taken to the Internet to explain that autism is an an incredibly complex condition that has a strong genetic link, with more than one hundred related genes identified so far.

We also know that the age of the parents plays a role and some environmental factors too.

The link between autism and paracetamol is based on a review of forty six studies done by Harvard University and Mount Sinai Medical Center.

According to experts, the results were so inconsistent that a meta analysis was unable to be performed.

A meta analysis is where you combine the results of multiple independent studies to prove a single estimate or outcome.

It found some association in twenty seven of those studies, but the rest did not, and the lead author of the reviews stated that with these results they cannot answer the question about causation when it comes to answering whether there's any link between paracetamol use and autism.

A bigger study on whether there is a link was done by Swedish researchers who looked at two point five million children, including one hundred and eighty six thousand, that had been exposed to paracetamol and utero.

Their initial result was a five to seven percent increased risk of autism, but that didn't take into account the pregnant woman themselves who were taking the drug, because they were more likely to have been suffering from an infection or chronic pain, or who had ADHD or autism themselves.

And we know there is that genetic component to the disorder when they compared siblings.

When one child was exposed to paracetamolin utero and one wasn't, that initial association dropped to zero.

RFK Junior is also claiming that autism can be cured by treating a folate disorder.

Now we know that folic acid is important during pregnancy to ensure our baby's brains develop correctly.

It helps prevent serious neural tube defects like spina bifida, where the spine and spinal cord don't develop properly, and anencephoalle where the baby's skull and brain don't develop correctly.

The current research into the link between folate and autism is mixed.

There are some that suggest there is an increased risk of autism with high folid intake and some that suggest supplements can decrease the risk of autism, so at this point the science is not conclusive.

However, RFK Junior is claiming that luca vorn, a prescription medication which is a folate metabolite currently used to help people deal with the side effects of chemotherapy, can cure autism.

For pregnant and infants and toddlers.

Our research has revealed that folate deficiency and a child's brain can lead to autism.

We have also identified and exciting therapy that may benefit larger numbers of children who suffer from autism.

Peer reviewed literature has documented that up to sixty percent of folate deficient children with ASD and if improverable communications have given LUCA orin I have instructed NIHFDA and CMS helped doctors treat children appropriately.

However, there are no large scale studies to measure this claim against, with only a few very small trials currently underway.

There is a suggestion that some children with autism may show some improvement when it comes to things such as verbal communication.

That's due to some children with autism having auto antibodies that block folate from getting into their brains during development, but this has not been properly tested and that would only apply to some children with autism.

It is certainly not a cur all.

In response to this, Australia's Health Minister Mark Butler called on the TGA, the Therapeutic Goods Administration, to release their guidance for Australian pregnant women and those with autism or who have children who do.

And they said this the TGA has no current active safety investigations for paraceed tamil, an autism or paracy tamil, and neurodevelopmental disorders more broadly.

But if I was pregnant right now and hearing all this information, I would understandably be confused and concerned, and I would question whether I would start to wonder if I should stop taking paracetamol as a result.

But what do you take instead, if anything, and what are the risks you're putting yourself in if you don't.

I don't take something to deal with something like a fever when you're expecting.

We spoke to Scott White, a senior lecturer in maternal feed or medicine at the University of Western Australia.

Scott, thank you so much for joining us.

I wanted to get your opinion first up on how you respond as someone who is a medical professional who works specifically in medicine that deals with pregnant women and babies in euro how do you respond to claims like the ones that Trump and RFK have made.

Ideally sensitively, pregnancy is a time of joy and anxiety for all couples, for all women, and to hear statements like this is really quite concerning.

And it does make our job as health professionals more difficult.

So I'm going to spend most of today and probably most of the next couple of weeks debunking what's clearly a misapplication of the science.

Well, can we talk about that for a moment.

I have run through what science these claims were based on and how they are not in any kind of large way representative of the claims that Trump and RFK are making.

But can you definitively say that paracetamol does or does not cause autism?

Or are we at this stage where we just don't understand it enough.

My reading of the evidence is that we can definitively say that paracetamol exposure and pregnancy does not cause autism.

The evidence from earlier studies showed and association.

That's very clear.

But the biggest and most important study in this area is the study out of Sweden of two by five million children, which showed that the association which they demonstrated as well, completely disappeared when you're controlled for other factors that are associated with autism, not least the genetic factors, which they identified by both by looking at the siblings of those children and looking at neurodivergent diagnosis in the parents themselves.

Okay, well, let's look at then, the potential fallout of telling women that paracetamol causes autism.

So one of those will be that women will stop using it if they say, are in pain or experience a fever while they're pregnant.

Can we just talk about what implications that has.

Yeah, the science is clear that exposure to high fevers, either a fever from a virus or external high temperature that increases the mother's core temperature, increases the chance of developmental complications in that fetus after birtha and later in life, including neurodevelopmental complications.

So not treating a fever actually could well do harm.

Women need to be reassured that most women who get viruses at cuve fever in early pregnancy, their babies are going to be absolutely fine, but it's not providing that treatment, maybe doing more harm than good.

Can we also look at potentially women avoiding paracetamol and using other types of pain relief in its place.

What do we know about using say, ibuprofen or trying to swap in other things that potentially could help with the pain.

What impact might that have on our unborn babies.

Absolutely so, Paracetamol is clearly the safest medication to use to treat pain and fever in early pregnancy.

We know that people who use things like ibuprofen then nonstroidal and inflammatory dugs increases slightly, but again importantly the risk of miscarriage if it when taken in early pregnancy and in late pregnancy, they can do really very bad things to babies kidneys and baby's heart and are absolutely to be avoided.

The one thing that was concerning from what Trump mentioned today was using aspirin.

The way we use aspirin in pregnancy is very different to how we use aspirin outside of pregnancy to treat pain and fever.

There are women who are recommended to take a low dose of aspirin from early pregnancy to reduce the risk of potential complications of pregnancy like preclamps Yeah, that's been really clearly demonstrated to be absolutely safe and extremely beneficial in preventing early birth associa with those conditions, which again that early birth increases the chance of neurodevelopmental complications.

RFK has mentioned this foll late treatment for children who have autism and that it's being touted somewhat as a cure for autism.

I've explained why this claim is being made and the science that they are basing this on, and that it does not cover every child with autism, and that it may or may not be beneficial at this point.

But I guess there's warnings for people who might see this and go, Okay, if I just take a whole bunch of fol eate, this is going to ensure my baby doesn't get autism, or maybe they give their kids a whole bunch of folate in the hopes that it will fix it.

Like what do we do?

Like what do we need to make sure is in place as a warning sign and as a guide to make sure that doesn't happen.

See studies that are of kan Trump were alluding to other studies of using folinic acid or lucovorin in autistic children.

There have been some important studies done in this area, and some they're small, they're preliminary, but they do provide some evidence that using luca orin folinic acid may reduce some of the verbal challenges that autistic kids can have.

Is it a cure for autism?

No, it's not.

Do we need to cure autism, No, we don't.

Autisms are neurotype, not a disease.

So these are the things to think about.

Those studies are very preliminary.

Should they be evaluated further YEA, they absolutely should, because anything that we can do to make the life of an autistic child and their family better is something that we should look at.

But I wouldn't go out and buy a whole pile of this stuff expecting for it to make miraculous differences to the lives of your children, because that's not what the science suggests it will do.

At the moment, Scott, I wanted to ask you about Trump's message for women who are dealing with pain or fever during their pregnancy is really just a tough it out.

And as women, we've been told just to tough it out various ways when it comes to our health, whether it's comes to menstrual cycles or any kind of pain really developing from the pelvic area, or even when women hit things like perimenopause, we're kind of basically told to just kind of struggle through to the other side.

What message do you have for women who, I mean, understandably will be very concerned about this message, but also are told your pain is just something you have to suck up and get on with.

Yeah, a couple of things.

So we call this medical misogyny, and it's been around for far too long and it should be a thing of the past, but it's still not.

For generations, men have been telling women that what happens with their body is normal and they should just suck it up and deal with it.

Pain and fever in pregnancy are not normal, and they are completely is safe to treat and shouldn't be tolerated just because they're women.

There is good evidence from other areas of medicine where women's pain is treated less aggressively than it is in the same condition in men.

You know, women are often told, you know, suck it up.

The delayed diagnosis in endometriosis because women are told that period pain is normal.

There's so many examples, so many distressing examples of this in medicine, and this is just yet another one of them.

It is time for us, particularly us men, to stop telling women to suck things up.

What message can we leave women with today, Scott, who might be really worried right now, like, what will you be telling those women that you'll be seeing face to face who are concerned about this.

Claims that there's association a paracetam woral causes autism are really not supported in any way in evidence.

In fact, the evidence, rather than just being unclear, the evidence is very clear that parasitomal exposure in early pregnancy does not cause autism.

It's really very clear.

So we can be reassured by the science regardless of what Trump and r of Case say.

At the end of the day, when we use medications in pregnancy, we do so balancing the risks of you using that medication, the potential side effects of that medication, versus the benefits that we expect to get.

And there is significant benefit in treating pain and favor in pregnancy in terms of those pregnancy outcomes compared to the harm which we know very well for parasita or which has been studyed in such big studies to show there really is limited, if any risk at all.

And so we have those conversations to help women navigate that decision making.

But I guess take our message at any point in pregnancy, if you're worried about something, then speak to your midwile speak to your doctor, speak to the person who knows you best, who can help you navigate these decisions through your pregnancy.

If we look at this announcement from a purely political position, we've already seen how women's health has been weaponized in the Trump administration, which changes to abortion laws after Roe v.

Wade was overturned.

So could this be another deliberate strategy and why would they do that?

Well, there is a long history of public health fear being used to make women more compliant.

Fear is a highly effective tool when it comes to changing attitudes and behaviors.

When a leader raises health concerns about a common and trusted drug like paracetamol, that motivates us, especially those in a vulnerable position like during pregnancy and who are often the primary health decision makers in their family, to look for guidance and to those who have solutions, a solution like an untested cure for a condition that seemed light years away from having one.

We'll leave you with a comment from my co host over on Well our Women's Health podcast GP, doctor Merriam.

She posted this after the Trump RFK Junior announcement, and she is not impressed.

Autism is a complex disorder Okay, it's a condition with strong genetic underpinnings, not something triggered by a couple of paracetamol tablets.

Now, when politicians like Trump or conspiracy theorists try to play a doctor, it's not only laughable, it's actually dangerous.

Their medical knowledge is about as reliable as a Facebook common thread at two am and JFK Junior jumping on the bandwagon.

Please both of them can kiss my ass.

And here's the trip.

Paracetamo is one of the safest and most widely used medications globally.

It's recommended by the Well Talf Organization and used by millions millions every single day.

If it caused autism, we'd be seeing an epidemic that simply doesn't exist.

So let's stop spreading fear.

Let's stop spreading misinformation.

Medicine is about evidence, it's not about politics.

And for the record, I have a child with autism and I never took paracetamol.

Thanks for checking this out with us today.

Remember if you have any worries that we haven't addressed here, or even if we have, check in with your own doctor to make sure you're getting the right advice for you.

You can find a link to get your daily news update from the Quickie in our show notes, and make sure you check out our next episode of Well.

We're still in Perimenopaud's territory.

With this time, we're getting through all those bloody symptoms and there are a lot check out Well wherever you get your podcasts.

Mamma Mia acknowledges the traditional owners of the land.

We have recorded this podcast on Gatigal people of the eorination.

We pay our respects to their elders past and present, and extend that respect to all Aboriginal and torrest Rate Islander cultures.