Paracetamol should unequivocally remain the primary painkiller for pregnant women, a comprehensive and major scientific review has firmly concluded. This ruling comes after a period of global controversy sparked by claims suggesting that the drug, also known as acetaminophen or Tylenol in the US, could potentially elevate the risk of autism in children. For a long time, paracetamol has been regarded as the safest choice for expectant mothers experiencing pain, headaches, or fever. However, this established advice was challenged last year following controversial research, which was subsequently highlighted by the Trump administration, advocating for the avoidance of paracetamol during pregnancy due to concerns about its potential impact on children's brain development.

Leading obstetricians have now stated that an extensive review of the existing evidence demonstrates these fears are not substantiated by robust scientific data. Conversely, they caution that advising women to refrain from using paracetamol could inflict greater harm than good. Untreated pain and fever during pregnancy are well-known factors that increase the risk of adverse outcomes such as miscarriage, premature birth, and birth defects. The researchers involved in the review noted that the discussion surrounding paracetamol had become 'politicised,' causing 'confusion' for both pregnant women and healthcare providers. They stressed that avoiding the medication based on 'inconclusive or biased evidence' could result in fevers and pain going untreated, thereby jeopardizing pregnancies. Ultimately, they concluded that discouraging its appropriate use 'has the potential to cause greater harm than the drug itself'.

In what is described as a gold-standard review, researchers meticulously analyzed all the best available evidence regarding whether paracetamol increases the risk of ADHD, autism, or intellectual disability, finding no conclusive link. Dr. Asma Khalil, a consultant obstetrician and fetal medicine specialist at St George’s Hospital in London and a co-author of the study, affirmed, ‘We found no clinically important increase in the risk of autism, ADHD or intellectual disability in children whose mothers took paracetamol during pregnancy. An important message to the millions of pregnant women is that paracetamol is safe to use during pregnancy, and avoiding it without good evidence could cause harm.’

Paracetamol is currently recommended by the NHS for use during pregnancy, provided it is taken for short durations and at the lowest effective dose. Approximately half of pregnant women in the UK use the drug, a figure that rises to about 65 percent in the US. To reach their findings, the international research team examined 43 studies exploring connections between prenatal paracetamol exposure and neurodevelopmental outcomes. Seventeen of these studies were incorporated into a meta-analysis, allowing for the comprehensive combination of data from multiple sources. Crucially, the researchers placed significant emphasis on sibling-comparison studies. These studies compare children born to the same mother—one pregnancy involving paracetamol use and another without—which effectively helps to control for shared genetic, social, and environmental influences.

Across all analyses, including studies with more than five years of follow-up and those assessed to be at a low risk of bias, the researchers identified no evidence indicating that paracetamol use during pregnancy increased the risk of autism, ADHD, or intellectual disability. Sibling-comparison analyses, encompassing over 262,000 pregnancies, revealed no significant association with autism risk. Similarly, data derived from more than 502,000 pregnancies found no link between paracetamol use and intellectual disability. Furthermore, no heightened risk of ADHD was observed across any of the study designs. The authors therefore concluded: ‘Maternal use of paracetamol during pregnancy does not seem to increase the likelihood of autism spectrum disorder, ADHD, or intellectual disability.’

Commenting on these findings, Dr. Monique Botha, an expert in developmental psychology at Durham University who was not involved in the study, stated, ‘This is a strong and reliable study that addresses a question many people are understandably concerned about following the recent politicisation of the topic. When the highest-quality evidence is examined – particularly sibling-comparison studies – the findings are clear: there is no evidence that using paracetamol as recommended during pregnancy increases the risk of autism, ADHD or intellectual disability.’ Professor Ian Douglas, from the London School of Hygiene and Tropical Medicine, added that by excluding studies where apparent harms were likely attributable to differences between women rather than the drug itself, the review successfully ‘reduced the unhelpful noise’ that has contributed to public confusion.

This major review follows comments made by Donald Trump at the White House in September 2025, when he urged pregnant women to ‘tough it out’ and avoid paracetamol, asserting it contributed to increasing autism rates – remarks that were widely criticized by the medical community. Since then, several significant reviews have consistently found no convincing evidence linking paracetamol use in pregnancy to neurodevelopmental disorders. The National Autistic Society reports that over one in 100 people in the UK are autistic, clarifying that autism is not a disease and is present from birth. Meanwhile, NHS figures indicate that more than 230,000 individuals in England are prescribed ADHD medication. Experts largely attribute the rise in diagnoses to improved awareness, expanded screening practices, and reduced stigma surrounding these conditions, rather than a causal link with paracetamol.