Taking paracetamol in pregnancy does not raise risk of autism or ADHD

Adelaide: For many expecting parents, the question of whether it is safe to take paracetamol during pregnancy can be a source of worry. A fever, headache, or back pain can prompt hesitation: is a simple painkiller safe for the baby?

Concerns intensified last September when the United States government suggested a possible link between paracetamol use in pregnancy and developmental conditions such as autism and attention-deficit hyperactivity disorder (ADHD).

Now, a major international review published in The Lancet provides reassuring evidence. The study confirms that taking paracetamol, also known as acetaminophen or by brand names such as Panadol and Tylenol, does not increase the risk of autism, ADHD, or intellectual disability in children when used during pregnancy. Paracetamol remains a safe and effective option for treating pain and fever at any stage of pregnancy.

The researchers conducted a large systematic review and meta-analysis, combining data from many previous studies rather than relying on a single group. In total, 43 studies examining the effects of prenatal paracetamol exposure on children’s neurodevelopment were analysed.

Importantly, the review prioritised sibling -comparison studies. These studies compare siblings within the same family, where one sibling was exposed to paracetamol in the womb and the other was not. By controlling for shared genetics, home environment, and family background, this method minimises confounding factors that can distort results. Advanced statistical methods were also applied to ensure accuracy.

Across these higher- quality studies, there was no meaningful increase in the risk of autism, ADHD, or intellectual disability among children whose mothers took paracetamol during pregnancy. This conclusion held true when the authors looked only at sibling-comparison studies, focused on studies with a low risk of bias, and examined children followed for more than five years. Earlier studies suggesting a link appear to have been affected by confounding factors, such as genetic or environmental differences, which the more rigorous methods accounted for.

The findings align with a landmark Swedish study published in 2024, which analysed almost 2.5 million children born between 1995 and 2019. That research also demonstrated that apparent risks of autism and ADHD disappeared when sibling-comparison methods were applied, highlighting the importance of robust controls in research.

Paracetamol is not just another medication. It is often the only recommended treatment for pain and fever during pregnancy. Australia’s Therapeutics Goods Administration continues to classify paracetamol as a pregnancy “Category A” drug, indicating it is safe when used as directed.

Managing fever in pregnancy is crucial. Untreated fever has been associated with miscarriage, pre-term birth, and other complications. Avoiding paracetamol “just in case” may, in fact, carry greater risks than taking it responsibly. For pregnant people deciding whether to take paracetamol for a fever or pregnancy-related aches, these findings provide reassurance: the medication remains safe, effective, and evidence-based, and has been the first-line option for decades. Individuals with concerns should consult their healthcare provider.