Paracetamol in pregnancy: what the evidence actually shows

Paracetamol in pregnancy: what the evidence actually shows

Key takeaways

• There is no conclusive evidence that paracetamol causes autism or ADHD in children
• Most studies showing an association are retrospective – they can suggest a link but cannot prove cause and effect
• Occasional, short-term use of paracetamol in pregnancy is unlikely to be harmful
• Prolonged or high-dose use should be approached with caution and discussed with your doctor
• Pregnant women should never stop or avoid medication without speaking to their healthcare team first

In September 2025, US President Donald Trump told pregnant women to “tough it out” and avoid paracetamol, citing an unproven link to autism. The comments caused immediate confusion and alarm – including here in Australia, where paracetamol is one of the most commonly recommended pain relief options during pregnancy.

I want to give you a clear, evidence-based picture of what we actually know, because the last thing a pregnant woman needs is to make decisions about her health based on a political statement rather than the science.

What prompted the warning?

Trump’s comments were based on a literature review published in August 2025 that examined whether paracetamol taken during pregnancy is associated with adverse outcomes in children, particularly ADHD and autism spectrum disorder.

It is important to understand what this review was and was not. It did not present new experimental findings. It synthesised and critiqued existing studies – most of which were retrospective in design. That means researchers looked back at what happened after the fact, rather than conducting a controlled experiment.

Retrospective studies can identify associations. They cannot prove cause and effect.

Why the research is harder to interpret than it looks

Here is a straightforward example of why this distinction matters.

One of the most common reasons pregnant women take paracetamol is to manage fever. If a later analysis shows that children of mothers who took paracetamol during pregnancy have higher rates of developmental difficulties, how do we know whether the medication was responsible – or whether the fever itself contributed to the outcome? Fever during pregnancy carries its own risks to foetal development. Separating the two is genuinely difficult.

A large Swedish study that used sibling comparisons – a much stronger study design that controls for shared family factors – found no association between paracetamol use in pregnancy and autism when those family factors were accounted for. This is an important counterpoint to the studies Trump was referencing, and it did not make headlines in the same way.

The evidence, in short, is mixed. And mixed evidence is not the same as evidence of harm.

What does this mean for you?

The Australian Medical Association has been clear: there are no studies showing that paracetamol use in pregnancy causes autism. The balance of current evidence indicates that occasional, short-term use of paracetamol during pregnancy is unlikely to be harmful to your baby.

Where caution is warranted is with prolonged or high-dose use. This is not specific to paracetamol – it reflects a broader principle that applies to all medications during pregnancy. Every medication should be used only when clearly necessary, at the lowest effective dose, and for the shortest possible time.

This is the same principle I apply when advising my own patients.

The risk of the other direction

There is something important that got lost in the coverage of Trump’s comments, and I want to name it directly.

Untreated fever during pregnancy carries real, documented risks – including to foetal brain development. If pregnant women avoid paracetamol out of fear and allow a high fever to go untreated, that is not a neutral choice. It is a choice with its own consequences.

The goal is not to avoid all medication. It is to make informed, proportionate decisions with your healthcare team – weighing the risk of the condition being treated against the risk of the treatment itself.

My advice

If you are pregnant and have been worried by what you have heard about paracetamol, please do not make any changes to how you manage pain or fever without speaking to your doctor or midwife first.

If you need paracetamol for a short-term reason – a headache, a mild fever – occasional use at the recommended dose is not something the current evidence suggests you need to be alarmed about.

If you have persistent or recurring symptoms that require ongoing pain management, that is a conversation to have with your healthcare team so you can find the most appropriate approach for your situation.

If you have questions about managing your health safely during pregnancy, get in touch to book a consultation.

References

National News Network, September 2025. Trump pregnancy warning: What experts say about paracetamol risks. Read the full article here