Comprehensive Lancet Review Finds No Link Between Paracetamol Use During Pregnancy and Autism or ADHD in Children
Key Insights
A comprehensive review of 43 studies published in The Lancet (search) found no evidence that paracetamol use during pregnancy increases the risk of autism spectrum disorder (search), ADHD (search), or intellectual disability (search) in children.
The analysis, which included more than a million births and prioritized sibling-comparison studies to control for genetics and environmental factors, contradicts previous claims linking the medication to neurodevelopmental disorders.
Medical authorities including the MHRA reaffirmed that paracetamol remains the safest first-line treatment for pain and fever during pregnancy when taken as directed.
A comprehensive systematic review and meta-analysis published in The Lancet (search) Obstetrics, Gynaecology, & Women's Health has found no evidence that paracetamol use during pregnancy increases the risk of autism spectrum disorder (search), ADHD (search), or intellectual disability (search) in children. The findings directly contradict recent claims that have created confusion among pregnant women about the safety of this widely-used medication.
Robust Analysis of Over One Million Births
The research team, led by Professor Asma Khalil from City St George's, University of London (search), analyzed 43 high-quality studies encompassing more than a million births. The review prioritized sibling-comparison research, which offers particularly strong evidence because it controls for shared genetics and environmental factors that could confound results.
"We found no clinically important increase in the risk of autism, ADHD (search) or intellectual disability (search) in children where the mothers took paracetamol during pregnancy," Professor Khalil stated. "The important message to the millions of pregnant individuals is that paracetamol is safe to use in pregnancy."
Previous Research Likely Distorted by Confounding Factors
One of the largest studies relied upon in the review was a 2024 Swedish study examining more than two million births that compared siblings. This research concluded that previous studies reporting links between paracetamol and autism had likely been distorted by genetics, environmental factors, or health conditions affecting the mother.
The researchers noted that pregnant women tend to overestimate medication-related risks and can be particularly susceptible to misinformation. "Limited understanding of the underlying causes of ADHD (search) and autism spectrum disorder (search) could leave affected mothers particularly susceptible to self-blame," the authors wrote.
Regulatory Authorities Reaffirm Safety Profile
Following the publication, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) reaffirmed paracetamol's safety profile during pregnancy. Dr Alison Cave, Chief Safety Officer at the MHRA, emphasized that "paracetamol remains safe to use during pregnancy" and continues to be "the recommended first choice for treating pain or fever during pregnancy."
In Australia, paracetamol maintains its category A classification during pregnancy, indicating it has been taken by large numbers of pregnant women without proven increases in harmful effects on babies.
Potential Harm from Avoiding Treatment
The researchers emphasized that discouraging appropriate paracetamol use could pose greater risks than the medication itself. "Untreated maternal fever, in particular, has been linked to miscarriage, congenital anomalies, preterm birth, and differences in neurodevelopment," the paper stated.
Professor Khalil reinforced this point: "Paracetamol remains to be the first-line treatment that we would recommend if pregnant women have pain or fever. Our findings suggest that previously reported links are likely to be explained by genetics or other factors such as fever or underlying pain, rather than a direct effect of the paracetamol itself."
Addressing Scientific Misinformation
The review comes in response to what researchers described as the "politicisation of scientific uncertainty" that has created confusion among pregnant people. The analysis specifically addresses concerns raised by previous claims linking paracetamol to neurodevelopmental disorders.
David Trembath, head of autism research at CliniKids (search), The Kids Research Institute Australia, expressed confidence that the comprehensive evidence should put concerns "to bed." He noted that while misinformation can be difficult to counter even with robust evidence, healthcare providers can offer clear guidance based on the consistent scientific evidence.
Dr Monique Botha from Durham University praised the research methodology: "This is a strong and reliable study that addresses a question many people are understandably worried about. The researchers reviewed all the best available evidence."
Clinical Implications
The findings reinforce current clinical guidelines across multiple healthcare systems. The NHS maintains that "paracetamol is the first choice of painkiller if you're pregnant" and "does not harm your baby" when taken as directed.
While the researchers acknowledged limitations in their analysis, such as being unable to control for specific timing and dosage of paracetamol use, they expressed hope that their findings would eliminate skepticism about using paracetamol during pregnancy when medically appropriate.