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Current evidence does not support a causal link between paracetamol use in pregnancy and autism spectrum disorder. A 2025 review of pivotal studies concluded that in-utero exposure to paracetamol is unlikely to confer a clinically important increased risk of ASD, and clinical guidelines on treating pain and fever in pregnancy should not change. Untreated pain and fever can harm both mother and fetus; when needed, paracetamol remains the recommended option.

Pregnant woman with a pill in her fingers

The UK Teratology Information Service (UKTIS), the MacDonald Obstetric Medicine Society (MOMS), and the British Maternal and Fetal Medicine Society (BMFMS) have issued a joint statement on the use of paracetamol during pregnancy and its possible association with autism spectrum disorder (ASD).

Paracetamol is one of the most commonly used medicines in pregnancy and is generally considered the drug of choice for managing pain and fever. A large number of studies have examined potential neurodevelopmental outcomes following in utero exposure to paracetamol, but results have been inconsistent.

A recent 2025 review of key epidemiological studies concluded that paracetamol use during pregnancy is unlikely to confer a clinically important increased risk of autism spectrum disorder. The evidence does not support any change to current clinical guidelines for the management of pain and fever in pregnancy.

The statement emphasises that effective treatment of maternal pain and fever is important for the health of both mother and baby. Untreated pain and fever can negatively affect maternal wellbeing and daily functioning, and may increase risks for the fetus, including miscarriage, growth restriction, malformation, and preterm birth.

Paracetamol remains the recommended treatment option during pregnancy. Other alternatives, such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids, or gabapentinoids, are either associated with greater risks or lack sufficient safety data for use in pregnancy.

While some studies have suggested a possible link between prenatal paracetamol exposure and ASD, these have been limited by important methodological weaknesses, including selection bias and inadequate adjustment for genetic and familial factors known to influence ASD risk. Studies that control for these confounders, such as those using sibling comparisons, report much weaker or no associations.

The joint statement concludes that there is no good evidence that paracetamol use in pregnancy causes ASD, and that avoidance of paracetamol when clinically indicated could itself result in harm. Pregnant women who have concerns about paracetamol use are advised to discuss them with their healthcare professional.

 

Read the full story on the Nuffield Department of Women's & Reproductive Health website.