Pregnant women can take paracetamol safely without increasing the risk of their child developing autism, ADHD or intellectual disabilities, according to a study published in The Lancet Obstetrics, Gynaecology & Women’s Health.
The study, led by researchers at City St George’s, University of London, was carried out in response to public concerns sparked in 2025 by claims that paracetamol use during pregnancy might affect a child’s brain development.
Those earlier claims were based on studies that found small associations between paracetamol and conditions such as autism, but those studies had significant limitations. Many did not account for the fact that the conditions themselves, or the reasons a mother might take paracetamol in the first place such as fever or chronic pain, could run in families and affect results.
To get a clearer picture, the researchers analysed 43 studies using the most rigorous methods available. Crucially, they focused on studies that compared siblings born to the same mother, where one pregnancy involved paracetamol use and another did not. This approach helps rule out the influence of shared genetics, family environment and other parental factors that can skew results in standard studies.
Across these sibling comparison studies, the data covered over 262,000 children assessed for autism, more than 335,000 for ADHD and over 406,000 for intellectual disability. The conclusion was consistent across all three conditions: taking paracetamol during pregnancy was not linked to any increased risk.
“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,” said Professor Asma Khalil, Professor of Obstetrics and Maternal Fetal Medicine at City St George’s and Consultant Obstetrician.
The researchers also assessed the quality of all 43 studies using a recognised tool for evaluating research bias. The finding held up even when looking only at the highest quality studies and those with follow-up periods of more than five years. The authors note that they were unable to break down the results by trimester, how frequently paracetamol was taken, or the sex of the baby, as too few of the existing studies reported these details. They say further research in these areas would be valuable.
Overall, the findings back the guidance already given by major medical organisations worldwide. The researchers warn that avoiding paracetamol for significant pain or fever during pregnancy carries its own risks, particularly from untreated high temperature, and hope this study will put remaining doubts firmly to rest.
D’Antonio F, Flacco M, Valle L et al. Prenatal paracetamol exposure and child neurodevelopment: a systematic review and meta-analysis. The Lancet Obstetrics, Gynaecology, & Women’s Health, 2026; 2, e190-e198