Paracetamol in Pregnancy: Major Review Confirms Safety, Refutes Autism Claims

A major new scientific review has delivered a definitive verdict on a heated medical debate: paracetamol is safe to use during pregnancy. Published in The Lancet Obstetrics, Gynaecology & Women's Health, the research rigorously analyzed decades of data and found no link between the common painkiller and an increased risk of autism, ADHD, or intellectual disability in children. This conclusion directly challenges controversial claims that have caused significant confusion and anxiety among expectant mothers and healthcare providers worldwide.

The Gold-Standard Review

The review is considered a "gold-standard" analysis due to its rigorous methodology. Researchers examined 43 of the most robust studies on paracetamol use during pregnancy, involving data from hundreds of thousands of women. A key strength was the focus on high-quality studies that compared pregnancies where the mother had taken paracetamol to those where she had not, including sibling studies. This approach allows researchers to control for other influencing factors like genetics and family environment, providing clearer evidence of cause and effect.

Lead study author Professor Asma Khalil, a consultant obstetrician and professor of maternal fetal medicine at City St George's, University of London, stated the findings are clear. "When we did this analysis, we found no links, there was no association, there's no evidence that paracetamol increases the risk of autism," she told the BBC. "The message is clear – paracetamol remains a safe option during pregnancy when taken as guided." The review also specifically included studies with a low risk of bias and those that followed children for more than five years, further strengthening its conclusions.

Refuting Controversial Claims

The review's publication follows a period of significant public controversy sparked by statements from US President Donald Trump. In September 2025, President Trump claimed in a speech that his administration was linking paracetamol (known as acetaminophen in the US) to autism and urged pregnant women to "fight like hell" not to take it, calling the drug "no good". These claims were immediately criticized by medical organizations globally for lacking robust scientific evidence and causing unnecessary alarm.

The US Food and Drug Administration (FDA), while issuing a letter urging clinicians to be cautious, also stated on its website that "a causal relationship" between the drug and neurological conditions "has not been established" and that it remained the only drug approved for treating fevers during pregnancy. The new Lancet review aims to settle this debate conclusively. Professor Ian Douglas from the London School of Hygiene and Tropical Medicine praised the review as "well-conducted" for excluding lower-quality studies that failed to account for important differences between mothers.

Reinforcing Global Health Guidance

The findings strongly reinforce existing guidance from major health bodies in the UK, US, and Europe, which have consistently maintained that paracetamol is the safest pain relief option during pregnancy. Experts emphasize that the real danger lies in not treating pain or fever. High fever during pregnancy can increase the risk of miscarriage, premature birth, or developmental problems in babies. Paracetamol is the first-line treatment recommended to manage these conditions safely.

Professor Grainne McAlonnan from King's College London highlighted the importance of these reassuring findings for maternal mental health, noting that expectant mothers "do not need the stress of questioning whether medicine most commonly used for a headache could have far reaching effects on their child's health." Professor Jan Haavik, a molecular neuroscientist at the University of Bergen, stated the study provides "strong evidence" that should "effectively put this question to rest."

Conclusion and Key Takeaways

This comprehensive review serves as a powerful corrective to misinformation and provides much-needed clarity for healthcare providers and pregnant women. The consensus from the global medical community is now stronger than ever: paracetamol, when used as directed, is a safe and essential medication for managing pain and fever during pregnancy. Women should feel confident following their doctor's advice and current national health guidelines, which recommend paracetamol as the primary painkiller. The research underscores that autism is understood by scientists to result from a complex mix of genetic and environmental factors, not from the appropriate use of this common and well-established medication.