Extract from ABC News
There is no evidence using paracetamol during pregnancy increases the risk of autism, according to new research from The Lancet. (ABC Science: Tegan Taylor)
In short:
A world-leading journal, The Lancet, has found no evidence that using paracetamol during pregnancy increases the risk of developmental harm.
In September, the Trump administration advised pregnant women to limit the use of paracetamol during pregnancy.
What's next?
Experts say women should feel reassured paracetamol is a safe option when they are pregnant.
There is no evidence using paracetamol during pregnancy increases the risk of autism in children and discouraging its use could cause more harm than the drug itself, according to new analysis by one of the most prestigious medical journals in the world.
A comprehensive review of evidence, published in The Lancet, has reinforced advice from peak medical bodies across the world that paracetamol is safe to take during pregnancy.
The paper comes just months after the Trump administration advised pregnant women to limit the use of acetaminophen — also known as paracetamol — arguing it was linked to autism in children.
"Don't take Tylenol … Tylenol is not good," US President Donald Trump said at the time, using the drug's American brand name.
The advice was quickly condemned by medical experts as baseless and causing unnecessary fear, while Australians with autism said they felt they were being "scapegoated".
Now, an analysis of 43 existing studies, published in The Lancet Obstetrics, Gynaecology, & Women's Health journal, has found the strongest available evidence does not support a link between paracetamol use during pregnancy and neurodevelopmental harm.
"This [review] found no evidence that maternal paracetamol use during pregnancy increases the risk of autism spectrum disorder, ADHD or intellectual disability among children," the paper stated.
The researchers, from a range of European countries, said the "politicisation of scientific uncertainty" had created confusion among pregnant people, which could put them in danger.
"Avoidance of paracetamol based on inconclusive evidence could expose pregnant women and their babies to known risks associated with untreated fever or severe pain,"the paper stated.
"Untreated maternal fever, in particular, has been linked to miscarriage, congenital anomalies, preterm birth, and differences in neurodevelopment.
Donald Trump and Secretary of Health and Human Services Robert F. Kennedy Jr have previously raised concerns about the use of paracetamol during pregnancy. (Reuters: Kevin Lamarque)
"For this reason, discouraging the appropriate use of paracetamol has the potential to cause greater harm than the drug itself."
In Australia, paracetamol is considered a category A medication during pregnancy, which means it has been taken by a large number of pregnant women without any proven increase in any direct or indirect harmful effects on their babies.
"The message is clear: paracetamol remains a safe option during pregnancy when taken as guided," said the study's lead author, Asma Khalil, Professor of Obstetrics and Maternal Fetal Medicine at City St George's, University of London.
"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."
Previous research likely distorted by genetics and other facts
The review prioritised sibling-comparison research, with commentary published alongside the paper saying it offered "strong evidence" because they controlled for shared genetics and environmental factors.
One of the largest studies it relied on was a 2024 study on more than two million births in Sweden which compared siblings.
The study concluded that previous research, which had reported a link between paracetamol and autism, had likely been distorted by genetics, environmental factors or health conditions affecting the mother.
"The well established tendency for autistic traits to run in families, are more plausible explanations for previously observed associations than any direct effect of paracetamol."
David Trembath is head of autism research at CliniKids, The Kids Research Institute Australia. (Supplied)
They noted pregnant women tended to overestimate the risk of medication-related harms, and could be overly susceptible to misinformation and shame.
"Limited understanding of the underlying causes of ADHD and autism spectrum disorder could leave affected mothers particularly susceptible to self-blame."
The authors said while there were limitations around their research, such as being unable to control for factors like when and how much paracetamol pregnant women were taking, they hoped their findings would put an end to "any scepticism on using paracetamol".
David Trembath, head of autism research at CliniKids, The Kids Research Institute Australia, said while Mr Trump had a "very loud microphone" the results of the study should put concerns about paracetamol use in pregnancy "to bed".
Experts say women must not avoid taking paracetamol because of the US president's comments. (Adobe Stock: fizkes)
"Unfortunately, we do live in a world where sometimes messages catch hold and it's hard to, even with the most comprehensive evidence, such as from a review like this, it's kind of hard to take them out of people's minds," Professor Trembath said.
"But I'm really confident that if people talk to their GPs, their doctors, et cetera, that they'll be able to provide a really clear picture of the evidence … which is clear and consistent that there is no association between paracetamol and autism, ADHD and intellectual disability in kids."
He also noted discussions around paracetamol use in pregnancy causing autism, and the portrayal of the condition as something inherently negative could be upsetting to people with autism.
Trump links paracetamol with autism. What’s the evidence?
"I'm really sad that people have had to go through this whole series of events, but I'm hoping that this will put an end to it, that we can get back to focusing on what really matters.
"And that is giving people with disability all of the same opportunities that are readily available to their peers, and focusing on how to support people to live the best life possible."
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