Taking paracetamol during pregnancy does not increase the risk of autism, attention-deficit hyperactivity disorder (ADHD), or intellectual disability among children. That is according to the most rigorous analysis of the evidence to date published today in The Lancet Obstetrics, Gynaecology & Women’s Health, and led by researchers from City St George’s, University of London.
Researchers conducted a systematic review and meta-analysis of 43 existing studies to determine whether paracetamol was safe to use in pregnancy or not. This was in response to public concerns following claims back in September 2025 that suggested taking paracetamol during pregnancy might impact the neurodevelopment of those children and increase their risk of autism.
The claims were based on earlier studies that reported small associations between paracetamol in pregnancy and increased risks of autism. However, these were often based on studies prone to biases, including being limited by the type of data collected and not exploring comparisons between siblings to account for family history, which is vital information.
The team looked at 43 studies with the highest quality and most rigorous research methods and compared pregnancies where the mother had taken paracetamol to pregnancies where they had not taken the drug.
They pooled the results of sibling comparison studies that compared siblings born to the same mother, where one pregnancy involved paracetamol exposure and another did not. This design helps control for shared genetics, family environment and long-term parental characteristics that traditional studies cannot fully account for.
Across the sibling-comparison studies, data included 262,852 children assessed for autism, 335,255 for ADHD and 406,681 for intellectual disability. When compared to pregnancies with no exposure to paracetamol, it was confirmed that taking paracetamol in pregnancy was not linked to childhood autism, ADHD or intellectual disability.
Professor Asma Khalil, Professor of Obstetrics and Maternal Fetal Medicine at City St George’s, University of London and Consultant Obstetrician, who led the study said:
“Our findings suggest that previously reported links are likely to be explained by genetic predisposition or other maternal factors such as fever or underlying pain, rather than a direct effect of the paracetamol itself.
“The message is clear – paracetamol remains a safe option during pregnancy when taken as guided. This is important as paracetamol is the first-line medication we recommend for pregnant women in pain or with a fever, and so they should feel reassured that they still have a safe option to relieve them of their symptoms.”
All studies were assessed for their quality based on the Quality In Prognosis Studies (QUIPS) tool that evaluates numerous factors in the way the research has been conducted to determine the risk of bias, another strength of this work. The lack of association between taking paracetamol during pregnancy and the risk of the child having autism, ADHD or intellectual disabilities also remained in the studies deemed to be at low risk of bias (and therefore highest quality), and in those which had a longer follow-up period of over five years.
The authors note that a limitation of the current study was that it was not possible to analyse smaller groups in the studies with sibling comparisons based on which trimester of pregnancy paracetamol was consumed in, sex of the baby or how often paracetamol was taken, because too few of the existing studies reported these data.
Overall, the findings of the study support the recommendations made by major medical organisations worldwide. The researchers hope that this gold-standard review will put an end to any scepticism on using paracetamol during pregnancy as avoiding paracetamol for significant pain or fever can expose both mother and baby to known risks, particularly untreated maternal fever.
