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It is really disappointing to see misinformation about paracetamol in pregnancy all over my social media feeds. The White House press release makes it sound like studies on paracetamol use during pregnancy are unbiased, but that is simply not true. All of these studies carry bias because they are retrospective or case-control, and many depend on recall, which is bias by definition.

Some reports pick apart studies that found no link, like sibling studies, but do not hold the same standard for studies that suggested an association. Even studies claiming to control for confounders often did not. Terms like “fever” and “infection” were frequently undefined, and chart reviews skew the data because fever or pain is almost always documented when paracetamol is given but not when it is not.

The best evidence comes from JAMA 2024 (PMID: 38592388). Researchers followed over 185,000 children exposed to paracetamol in utero and found no association between maternal paracetamol use and neurodevelopmental disorders such as autism or ADHD when correct analyses were performed. When multiple pain relievers were evaluated, all initially showed associations with neurodevelopmental disorders, but these disappeared in sibling-control analyses, pointing strongly to genetics as the main driver.

Studies that suggest a link have serious flaws. They fail to control for all confounders, which makes it look like paracetamol is associated with autism when it is not. Even if there were a link, the difference in autism rates between those who used paracetamol and those who did not is very small. The vast majority of pregnant people who took paracetamol did not have children with autism.

Paracetamol is safe for pregnancy when used as recommended, at the lowest effective dose for the shortest necessary time under the guidance of your doctor . It is the standard of care for treating pain or fever in pregnancy and can be used alongside other medications and under the guidance of your consultant. Uncontrolled fever above 100.4°F in the first trimester increases risks like miscarriage, neural tube defects, congenital heart issues, stillbirth, and preterm delivery. Managing fever safely during pregnancy is far more important than avoiding medication based on speculation, and guidance should be from your doctor.

It is even more frustrating when messaging from the Trump administration tells pregnant people to just “tough it out.” As someone who has been through three pregnancies myself, I know how dangerous and unrealistic this is. I took paracetamol in all three. I experienced pre-eclampsia in my first pregnancy, a painful PUPPP rash in my third trimester, ongoing pelvic pain, and a few low-grade fevers from everyday illnesses at home just to name a few issues I had. Paracetamol, used alongside other medications and under the guidance of my consultant for a couple of other health conditions I had, allowed me to manage these issues safely and get through my pregnancies without unnecessary suffering or danger to me or my babies.

Pregnancy changes your body. Blood volume nearly doubles, the heart works harder, and organs shift to make room for a growing baby. Symptoms that might seem minor, like swelling, headaches, or pain, can be signs of serious complications such as pre-eclampsia. Messaging that tells mothers to tough it out sends the harmful message that their pain and concerns are not worth addressing. Multiple studies show that when people feel their concerns will be dismissed, they often delay seeking care. Delaying care in pregnancy can be dangerous for both mother and baby.

Pregnant people deserve validation, respect, and timely care. Your comfort and health matter. You should never feel like you have to endure pain or symptoms because someone thinks you need to be “tough enough.” If you are uncomfortable, in pain, or unwell, speak with your consultant or doctor. Being proactive is always better than ignoring symptoms.

Bottom line, paracetamol in pregnancy is safe and does not cause autism or ADHD going by the current research . Neurodevelopmental disorders are multifactorial, with genetics playing the leading role. Pregnancy is hard enough without messaging that tells you to suffer in silence. Pregnant people already have enough to worry about without adding unnecessary fear about taking paracetamol. Please talk to your doctor or consultant about any concerns you have and they can give you informed advice and tailor it to your circumstances.

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