Neonatal circumcision was not associated with autism

Design

Prospective multisite cohort (ECHO)

Population

2771 boys, 1840 circumcised in the neonatal period

Primary outcome

Autism diagnosis and autism trait scores

Effect

Adjusted OR 0.83 (95% CI 0.59-1.17)

This prospective cohort drew on 14 sites of the US ECHO programme, including 2771 boys, two-thirds of whom were circumcised before discharge. Autism was identified from reported clinical diagnoses or standard assessments, and autism traits were measured with validated scales. Published in JAMA Pediatrics on 1 October 2026.

After adjustment, circumcision was not associated with autism (OR 0.83, 95% CI 0.59 to 1.17). Trait and behaviour scores also showed no association, and stratified analyses found no or inverse associations.

Claims linking circumcision, and paracetamol given around it, to autism have circulated widely. This adds reassuring data from a well-characterised cohort.

The study was observational and modest in size, so a very small effect cannot be excluded, but there is no signal to support the concern.

• Reassure parents that this cohort found no link between neonatal circumcision and autism
• Discuss circumcision on its usual merits, including adequate pain relief
• Use the conversation to explain how autism is assessed and when to raise concerns
• Refer for developmental assessment based on signs, not on past procedures

Why it matters

It answers a worry that circulates widely online with prospective data.

The statistics, in plain English

An odds ratio of 0.83 with a confidence interval from 0.59 to 1.17 crosses 1, so there was no detectable association in either direction.

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