JAMA Study Finds No Link Between Newborn Circumcision and Autism Risk
A large U.S. study involving nearly 2,800 boys found no evidence that neonatal male circumcision was associated with autism spectrum disorder or autism-related traits and behaviors. The prospective ECHO cohort findings also noted that acetaminophen use during circumcision was uncommon, providing further reassurance about the procedure's neurodevelopmental safety. The study was published in JAMA Pediatrics by Monica M. and colleagues.
The basic biological theories that suggested the connection between early circumcision and neurodevelopment were based on the effect of pain in infancy due to early procedural stress or perioperative administration of acetaminophen as a mild analgesic. In both cases, critics had suggested that the acute stress experience in early life may affect the neuroendocrine response to stress, or that the early use of acetaminophen will have an effect on neuroplasticity. Nonetheless, the biological evidence demonstrates that brief and localized surgeries under usual conditions for neonates do not interfere with the development of the central nervous system or the brain cortex.
Key findings:
- The study included 2,771 male infants at 14 different ECHO locations. Out of the 2771 children, 1840 infants (66%) underwent circumcision while 931 infant boys (34%) did not.
- In total, 192 infants (7%) were diagnosed to be on the Autism Spectrum at a mean (SD) age of 3.8 (2.2) years of age with 6% of circumcised infant boys diagnosed and 9% of uncircumcised infants diagnosed (108 out of 1840 in the first group while 84 out of 931 in the uncircumcised group).
- After controlling for confounding factors, authors found no link between the circumcision and autism diagnosis (OR, 0.83; 95% CI, 0.59–1.17) with inversed or none-existing association evident after dividing the study group by geographical location, prematurity, and hospitalization in a neonatal unit.
- Results of adjusted analyses showed no significant relation of circumcision with SRS-2 scores (beta = -0.62; 95% CI, -1.46 to 0,22) or in binary terms (OR, 0.75; 95% CI, 0.48–1.15).
- Authors also found no noteworthy findings concerning CBCL 1.5/5 T-scores ((beta = 0.01; 95% CI, -0.54 to 0.56 or in binary terms (OR, 1.30; 95% CI, 0.75–2.26) as well.
- Male infants who underwent circumcision, 31 (4%) received acetaminophen during the procedure and 128 (7%) received it in 30 days after delivering but it had no influence on the outcomes of the neurodevelopment.
Conclusively, this study found no link between NMC and ASD risk regardless of whether it was determined using parental report on professional diagnosis or autism behavioral tests. The results of this study can be encouraging for parents considering NMC for their children.
Reference:
McGrath M, Li X, Jacobson LP, et al. Neonatal Medical Male Circumcision and Child Autism Diagnosis. JAMA Pediatr. Published online August 03, 2026. doi:10.1001/jamapediatrics.2026.3239
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