Review finds no link between paracetamol use in pregnancy and autism, ADHD or intellectual disability
Current evidence does not link paracetamol use in pregnancy to autism, attention-deficit hyperactivity disorder (ADHD) or intellectual disabilities, according to a new review published in The Lancet Obstetrics, Gynaecology and Women’s Health. The findings directly counter recent public claims that the common painkiller—marketed in the United States as Tylenol—could be a cause of autism.
- Advertisement -
In September, US President Donald Trump said there had been a “meteoric rise” in autism cases and suggested pregnant women should avoid Tylenol and “tough it out.” His comments drew swift criticism from autism advocates and scientists.
The new paper brings together the most comprehensive assessment to date. An international team of researchers searched major databases for all studies reporting risk estimates for autism, ADHD and intellectual disabilities in children whose mothers took paracetamol during pregnancy versus those who did not. Eligible studies included validated medical records or questionnaires and considered mothers’ other conditions and treatments.
In total, 43 studies were included in a systematic review and 17 in a meta-analysis, which combines results across multiple studies to assess overall effects. The review also incorporated sibling-comparison studies—analyses that compare children born to the same mother, with paracetamol exposure in one pregnancy but not another—to better account for family history and shared environmental factors.
The authors concluded that paracetamol exposure during pregnancy was “not associated with the risk” of autism spectrum disorder, ADHD or intellectual disabilities. “Current evidence does not indicate a clinically important increase in the likelihood of autism spectrum disorder, ADHD, or intellectual disability in children of pregnant individuals who use paracetamol as directed, supporting existing recommendations on its safety,” they wrote.
Study lead author Professor Asma Khalil, a consultant obstetrician and fetal medicine specialist at St George’s Hospital, London, said the findings support current practice. “We found no clinically important increase in the risk of autism, ADHD or intellectual disability [among] children where the mothers took paracetamol during pregnancy,” she said. “And this is the important message to the millions of pregnant individuals: paracetamol is safe to use in pregnancy. It remains the first-line treatment that we would recommend if pregnant women have pain or fever in pregnancy, and it’s also consistent with recommendations or the guidelines by various national or international bodies.”
The conclusions align with existing guidance from drug regulators, including the European Medicines Agency, which has said paracetamol is safe to use in pregnancy when taken as directed.
Gráinne McAlonan, professor of translational neuroscience at King’s College London, said the study’s approach should reassure expectant mothers. “Expectant mothers do not need the stress of questioning whether medicine most commonly used for a headache could have far-reaching effects on their child’s health,” she said. “This thorough and clear study approached the question by conducting both a substantial systematic review of the literature and a meta-analysis of eligible studies. Importantly, it prioritised sibling design studies to account for family history, which is crucial.”
McAlonan added: “This confirmed that there is no relationship between taking paracetamol in pregnancy and a higher likelihood of autism, ADHD or intellectual disabilities in the offspring. While the impact of last year’s announcement has been extensive, I hope the findings of this study bring the matter to a close.”
The review’s message is straightforward: when taken as directed, paracetamol remains the recommended first-line option for pain and fever during pregnancy—and current evidence does not support claims that it increases the risk of autism, ADHD or intellectual disability in children.
By Abdiwahab Ahmed
Axadle Times international–Monitoring.
