Paracetamol and Pregnancy: What New Research Reveals About Autism Risk
Author: Azuka Chinweokwu Ezeike, MBBS, FWACS (Obstetrics & Gynaecology), FMCOG, MSc (Public Health)
Introduction
On September 22, 2025, U.S. President Donald Trump made a press statement cautioning mothers against taking paracetamol (known as Tylenol in the U.S), claiming it may be linked to autism. This statement was reportedly in response to rising autism cases in the country. It was based on research suggesting possible associations, although no specific study was mentioned.
The statement generated significant reactions in the medical community. Experts emphasised that, while a few studies have suggested a potential link, no direct causal relationship has been established, and other studies have found no link at all.
Responses from Medical Authorities
- U.S. Food and Drug Administration (FDA): Following the statement, the FDA began the process of reviewing paracetamol labelling to reflect current evidence. They also issued a letter to physicians, stressing the need for discretionary use, but clarified that paracetamol remains the safest painkiller during pregnancy.
- American College of Obstetricians and Gynaecologists (ACOG): ACOG reaffirmed that paracetamol is the analgesic and antipyretic of choice during pregnancy and advised judicious use.
- World Health Organization (WHO): WHO emphasised that no causal link has been proven between paracetamol and autism. They recommended that patients follow guidance from their doctors and health workers, and that medications be taken cautiously, especially during the first trimester of pregnancy.
Understanding Drug Use in Pregnancy
One of the challenges of prescribing medications during pregnancy is that almost all drugs cross the placenta. Medications are prescribed only when the benefits outweigh the risks. Paracetamol has been widely used in pregnancy for pain and fever relief and is considered the safest option available.
New Evidence on Paracetamol Use in Pregnancy
On January 16, 2026, a large study by D’Antonio et al, published in The Lancet, provided more clarity. This study found no association between paracetamol use during pregnancy and autism spectrum disorder, attention-deficit hyperactivity disorder (ADHD), or intellectual disability.
The authors noted that earlier studies suggesting a link may have been influenced by confounding factors such as genetics and environment, which were not fully accounted for.
Unlike prior studies conducted in the general population, this study focused on sibling comparisons to reduce confounding factors. It also used the Quality in Prognosis Studies (QUIPS) tool to minimise bias, making the findings more robust.
Implications for Pregnant Women
Paracetamol is commonly used during pregnancy to manage pain and fever. High, untreated fever in pregnancy can pose serious risks to the unborn child. Restricting its use without strong scientific evidence could be detrimental to maternal and fetal health.
Looking Ahead
Future research with careful study design and minimal confounding factors is needed to strengthen evidence regarding paracetamol use in pregnancy. In the meantime, the guidance of the FDA, ACOG and WHO should be followed, with avoidance of excessive use, but not complete restriction of this medication.
Source
D'Antonio, Francesco et al. Prenatal paracetamol exposure and child neurodevelopment: a systematic review and meta-analysis.The Lancet Obstetrics, Gynaecology, & Women’s Health. Available from: https://www.thelancet.com/journals/lanogw/article/PIIS3050-5038%2825%2900211-0/fulltext
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Published January 27, 2026