Paracetamol should remain the go-to painkiller for pregnant women, a major scientific review has ruled, after claims it could raise the risk of autism sparked global controversy.
The drug – also known as acetaminophen or Tylenol in the US – has long been considered the safest option for expectant mothers with pain, headaches or fever.
But that advice was thrown into doubt last year when controversial research, later seized on by the Trump administration, suggested paracetamol should be avoided in pregnancy amid fears it could affect children’s brain development.
Now senior obstetricians say a sweeping review of the evidence shows those fears are not backed up by robust science.
On the contrary, they warn that telling women to avoid paracetamol could do more harm than good, as untreated pain and fever during pregnancy are known to increase the risk of miscarriage, premature birth and birth defects.
The researchers said the debate around paracetamol had become ‘politicised’, ‘creating confusion’ for pregnant women and doctors alike.
They warned that avoiding the drug because of ‘inconclusive or biased evidence’ could leave fevers and pain untreated – putting pregnancies at risk.
In the end, they said, discouraging its proper use ‘has the potential to cause greater harm than the drug itself’.
Dozens of studies have already linked paracetamol, known as acetaminophen in the US, to the neuropsychiatric conditions
In a gold-standard review, researchers analysed all the best available evidence about whether paracetamol increases the risk of ADHD, autism or intellectual disability
Dr Asma Khalil, consultant obstetrician and fetal medicine specialist at St George’s Hospital in London and a co-author of the study, said: ‘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 in pregnancy, provided it is taken for short periods and at the lowest effective dose.
Around half of pregnant women in the UK use the drug, rising to about 65 per cent in the US.
To reach their conclusions, the international research team reviewed 43 studies examining links between prenatal paracetamol exposure and neurodevelopmental outcomes.
Seventeen of these were included in a meta-analysis, allowing data from multiple studies to be combined.
Crucially, the researchers gave particular weight to sibling-comparison studies, which compare children born to the same mother – one pregnancy involving paracetamol use and another without – helping to control for shared genetic, social and environmental factors.
Across all analyses, including studies with more than five years of follow-up and those judged to be at low risk of bias, the researchers found no evidence that paracetamol use during pregnancy increased the risk of autism, ADHD or intellectual disability.
Sibling-comparison analyses covering more than 262,000 pregnancies showed no significant association with autism risk.
Similarly, data from more than 502,000 pregnancies found no link between paracetamol use and intellectual disability.
No increased risk of ADHD was observed across any study design.
The authors concluded: ‘Maternal use of paracetamol during pregnancy does not seem to increase the likelihood of autism spectrum disorder, ADHD, or intellectual disability.’
Commenting on the findings, Dr Monique Botha, an expert in developmental psychology at Durham University who was not involved in the study, said: ‘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, of the London School of Hygiene and Tropical Medicine, added that by excluding studies where apparent harms were likely explained by differences between women rather than the drug itself, the review had ‘reduced the unhelpful noise’ that has fueled confusion.
The 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, claiming it contributed to rising autism rates – remarks that were widely criticised by medical experts.
Since then, several major reviews have found no convincing evidence linking paracetamol use in pregnancy to neurodevelopmental disorders.
According to the National Autistic Society, more than one in 100 people in the UK are autistic. Autism is not a disease and is present from birth, though it may not be recognised until later in life.
Meanwhile, NHS figures show more than 230,000 people in England are prescribed ADHD medication.
Experts say rising diagnoses likely reflect better awareness, expanded screening and reduced stigma, though debate continues about the role of environmental and biological factors.
