No link found between paracetamol in pregnancy and autism

Published: 10 November 2025. The English Chronicle Desk. The English Chronicle Online.

A comprehensive review of existing research has found no convincing evidence that paracetamol use during pregnancy increases the risk of children developing autism or attention deficit hyperactivity disorder (ADHD). The findings provide reassurance to expecting mothers and healthcare professionals amid recent public concern fueled by controversial statements from political leaders in the United States.

The review, published in the British Medical Journal on Monday, analysed previously published scientific reviews assessing the relationship between maternal paracetamol use and neurodevelopmental outcomes in children. The researchers conducted an umbrella review, synthesising data from nine systematic reviews encompassing 40 observational studies. Their conclusion was unequivocal: the quality of the studies ranged from “low to critically low,” and any apparent link between paracetamol use and autism or ADHD was more likely explained by family genetics and other confounding factors rather than the medication itself.

The timing of the review’s publication was particularly relevant. In September, then-U.S. President Donald Trump urged pregnant women to limit or avoid paracetamol, also known as acetaminophen or Tylenol, claiming that it contributed to rising rates of autism. His remarks prompted confusion and anxiety among pregnant women, with the president urging them to “fight like hell” to avoid using the common painkiller. Experts have repeatedly emphasised that such statements lacked scientific basis and risked spreading misinformation.

Prof Shakila Thangaratinam, consultant obstetrician and senior author of the review at the University of Liverpool, stressed that the findings should reassure women who might have felt guilty for taking paracetamol during pregnancy. “Women should know that the existing evidence does not really support a link between paracetamol and autism and ADHD,” she said. “If pregnant women need to take paracetamol for fever or pain then we would say please do, particularly because high fever in pregnancy could be dangerous to the unborn baby.” She added that alternative painkillers, such as ibuprofen, are generally not recommended during pregnancy.

The researchers meticulously examined nine systematic reviews, each assessing the potential association between paracetamol use and neurodevelopmental conditions. While all nine reported at least a possible link, seven of them cautioned against overinterpreting the findings, noting that they did not adequately account for other contributing factors such as family genetics or maternal health conditions. Only one review included studies that properly considered these confounding elements.

One of the pivotal studies included in the analysis focused on 2.4 million children in Sweden. It initially observed slightly higher rates of autism, ADHD, and intellectual disabilities among children whose mothers had taken paracetamol during pregnancy. However, when researchers compared siblings who were exposed to the drug with those who were not, the differences disappeared. This strongly indicated that the mother’s genetic background, pre-existing health conditions, or shared environmental factors were more likely responsible for the observed outcomes rather than the use of paracetamol itself.

“If there’s a family history of autism and ADHD, either in the parents or the siblings, then it is likely that that is the reason a child is diagnosed rather than something the mother took in pregnancy,” Thangaratinam explained. She added that the review helps prevent the undue stress and guilt that mothers may feel, noting, “They might have a child that is autistic with ADHD and we really don’t want them to think it’s because of something they did in pregnancy. That’s a terrible feeling for a mother to have.”

Prof Dimitrios Siassakos, honorary consultant in obstetrics at University College London, echoed these sentiments, emphasising that paracetamol remains the safest and most reliable medication for managing fever and pain during pregnancy. “Paracetamol is the safest medication to use in pregnancy, and has been used by the majority of pregnant women globally for several decades without any impact on autism and ADHD,” he said. He added that untreated fever or inflammation poses a far greater risk to fetal and neonatal brain development than paracetamol use, highlighting that high maternal temperature can negatively affect pregnancy outcomes.

The umbrella review underscores the importance of using high-quality, evidence-based information when making healthcare decisions during pregnancy. Experts involved in the study emphasised that misinformation can have tangible consequences, such as discouraging women from managing fever or pain, which can be dangerous for both mother and child.

While autism and ADHD prevalence has risen in recent decades, most researchers agree that this trend is primarily attributable to greater awareness, improved diagnostic practices, and broader criteria used by clinicians, rather than environmental or medicinal causes. The findings from the British Medical Journal review add another layer of reassurance, confirming that paracetamol, when used appropriately under medical guidance, does not contribute to the risk of these conditions.

Healthcare professionals continue to advocate for evidence-based guidance, urging pregnant women to consult with their doctors about any medications. Paracetamol remains the standard recommendation for managing pain and fever safely throughout pregnancy, reinforcing its critical role in maternal and fetal health.

In conclusion, the review offers clarity amid public concern, affirming that pregnant women should not feel culpable for using paracetamol when necessary. The strongest risk factors for neurodevelopmental conditions remain genetic and environmental, not the occasional use of a well-established painkiller. As the medical community continues to provide guidance grounded in robust scientific evidence, expectant mothers can confidently manage common pregnancy-related ailments without fear of inadvertently harming their children’s long-term health.