Paracetamol in pregnancy does not increase the risk of autism and Adhd in children: latest confirmation

Taking paracetamol during pregnancy does not increase the risk of autism, Adhd (attention deficit hyperactivity disorder) or intellectual disability in children. This is the new confirmation that comes from what experts call the most rigorous analysis of scientific evidence to date, published in 'The Lancet Obstetrics, Gynaecology & Women's Health'. It was conducted by researchers at City St George's, University of London.

There is no evidence of a link, note the authors, who completed a systematic review and meta-analysis of 43 existing studies to determine whether paracetamol was safe in pregnancy, in response to public concern after the US administration spoke out in September 2025 that it could increase the risk of autism in children. These claims were based on previous meta-analyses, which had suggested small associations between paracetamol in pregnancy and increased risk of autism and Adhd. But these, the experts point out, were often based on studies subject to bias, including limitations due to the type of data collected and the failure to explore sibling comparisons to account for family history, which is considered crucial information. This new review found that larger and more methodologically rigorous studies, such as those with sibling comparisons, provide strong evidence that paracetamol in pregnancy does not cause autism, Adhd or intellectual disability. The team adopted the most rigorous and high-quality research methods and compared pregnancies in which the mother had taken paracetamol with pregnancies in which she had not taken the drug. The authors state that the results suggest that previously reported associations between paracetamol in pregnancy and autism, Adhd or intellectual disability could be due to other maternal factors, such as latent pain, discomfort, fever or genetic predisposition, rather than a direct effect of paracetamol.

In detail, the authors combined data from comparative studies comparing siblings born of the same mother, in which one pregnancy involved exposure to paracetamol and the other did not. This scheme helps to account for shared genetics, family environment and long-term parental characteristics that traditional studies cannot fully account for. In the sibling comparison studies, the data included 262,852 children evaluated for autism, 335,255 for Adhd and 406,681 for intellectual disabilities. Comparing them with pregnancies without exposure to paracetamol, it was confirmed that paracetamol intake during pregnancy was not correlated with the diseases in question. 'Our results,' comments Asma Khalil, Professor of Obstetrics and Maternal-Fetal Medicine at City St George's, University of London, who led the study, 'suggest that the previously reported links are likely to be explained by genetic predisposition or other maternal factors such as fever or latent pain, rather than a direct effect of paracetamol itself. The message is clear: paracetamol remains a safe option during pregnancy if taken according to instructions. This is important, as it is the first-line drug we recommend to pregnant women suffering from pain or fever, and therefore they should feel reassured that they still have a safe option to relieve their symptoms'.

All studies were assessed for their quality on the basis of the Quality In Prognosis Studies (Quips) instrument, which evaluates numerous factors in the way research was conducted to determine the risk of bias, another strength of this work. The absence of an association between taking paracetamol during pregnancy and the risk of the child developing autism, Adhd or intellectual disability remained even in studies considered to be at low risk of bias (and therefore of the highest quality) and in those with a longer follow-up period of more than 5 years. A limitation of the current study, the authors point out, is that in studies with sibling comparisons it was not possible to analyse smaller groups according to the trimester of pregnancy in which the paracetamol was taken, the sex of the child or the frequency with which the drug was used, because the existing papers reporting this information were too few. Overall, however, the experts conclude, the study results 'support the recommendations made by leading medical organisations around the world'. The researchers hope that this landmark review will 'end any scepticism about the use of paracetamol in pregnancy', as avoiding it in cases of significant pain or fever 'may expose both mother and baby to known risks', particularly untreated maternal fever.