Reacción a "Researchers are investigating the link between paracetamol use during pregnancy and possible abnormalities in the reproductive development of baby girls"

Current Australian advice remains in place. That is, paracetamol can be used as directed for pain or fever during pregnancy, and this study alone should not prompt anyone to stop medically indicated use.

Residual confounding by indication is plausible and, in my opinion, likely. It is one of the major barriers to causal interpretation for this study. Although the authors examined fever specifically, the analyses do not adequately rule out confounding by the broader conditions for which paracetamol was taken, such as headache, pain or infection, which may themselves be associated with fetal development.

Our Epidemiology Research Laboratory applies specialised designs to address issues like this. What we want to know is whether it's the paracetamol or the reason it was taken. The informative comparison is within indication. Among women with the same condition (like headache or migraine), did those who took paracetamol differ from those who didn't?