Paracetamol use in pregnancy does not appear to increase risk of autism, ADHD or intellectual disabilities

Researchers report that paracetamol use during pregnancy does not raise the risk of autism, attention-deficit/hyperactivity disorder (ADHD), or intellectual disability among exposed children.

The findings were published on January 16, 2026 in The Lancet Obstetrics, Gynaecology, & Women’s Health journal.

As background, the authors noted, “Concerns have emerged about the impact of paracetamol use in pregnancy on child neurodevelopment, particularly in relation to autism spectrum disorder. We aimed to synthesize available evidence to investigate associations between prenatal paracetamol exposure and autism spectrum disorder, attention-deficit hyperactivity disorder (ADHD), and intellectual disability.”

The authors concluded, “This systematic review and meta-analysis found no evidence that maternal paracetamol use during pregnancy increases the risk of autism spectrum disorder, ADHD, or intellectual disability among children. The null findings remained consistent when analyses were harmonized to studies with longer follow-up, those employing sibling comparisons, and those at low risk of bias.”

They included 43 studies in this systematic review, and 17 studies in the meta-analysis.

The largest and most rigorous studies, specifically those with sibling comparisons, provided strong evidence that paracetamol-use during pregnancy is not a cause of autism, ADHD or intellectual disabilities.

Sibling comparison studies are designed to compare outcomes between siblings with different exposures (one sibling exposed to a drug, the other not) to control for shared genetic and environmental factors, and helping to isolate an accurate effect of exposure.

They reported that, when considering sibling comparison studies, paracetamol exposure during pregnancy was not associated with the risk of autism spectrum disorder (p=0·45), ADHD (p=0·31), or intellectual disability (p=0·63).

They also reported finding no association between paracetamol use during pregnancy and autism spectrum disorder (p=0·78), ADHD (p=0·49), or intellectual disability (p=0·28) when considering only studies at low risk of bias.

Low-risk-of-bias studies have strong designs, methods, and reporting, meaning their results are considered valid and reliable.

“This absence of association persisted when considering all studies with adjusted estimates and those with more than 5 years of follow-up,” they noted.

In an COMMENT appearing with the study, the authors said, “For now, this study reinforces that the strongest epidemiological evidence does not support a link between paracetamol use during pregnancy and neurodevelopmental harm, confirming that, when clinically-indicated, paracetamol remains an important and evidence-supported option for the management of fever and pain during pregnancy, particularly in settings where untreated maternal infection and fever pose well-established risks to fetal survival and neurodevelopment.