Sep 16, 2025 Pharmacist

Does the use of paracetamol during pregnancy cause autism?

Paracetamol Use in Pregnancy: What the Latest Research Really Says About Autism Risk

Recent media coverage around paracetamol use during pregnancy and autism has understandably caused concern among expectant mothers and healthcare professionals. With conflicting information circulating, we want to provide you with clear, evidence-based guidance on this important topic.

The Bottom Line: Paracetamol Remains Safe During Pregnancy

Paracetamol continues to be classified as Pregnancy Category A in Australia, meaning it is considered safe for use throughout pregnancy when used as directed. This classification is supported by the Therapeutic Goods Administration (TGA) and remains unchanged despite recent international discussions.

Understanding the Research Landscape

Autism is a complex neurodevelopmental condition influenced by multiple factors, including genetic predisposition and environmental influences. While some studies have suggested possible associations between paracetamol use during pregnancy and autism, these studies have significant methodological limitations that weaken their conclusions.

The Game-Changing Swedish Study

The most robust evidence to date comes from a comprehensive 2024 Swedish study published in JAMA - the largest epidemiological analysis ever conducted on this topic. This groundbreaking research examined nearly 2.5 million children born in Sweden between 1995 and 2019, with follow-up extending through December 2021.

Key findings from this landmark study:

No association found between paracetamol use during pregnancy and autism, ADHD, or intellectual disability
The study used sophisticated sibling-controlled analysis, comparing children exposed to paracetamol in utero with their unexposed siblings
This methodology effectively controls for genetic and environmental factors that could skew results
When proper controls were applied, any apparent links between paracetamol and neurodevelopmental conditions completely disappeared

Why This Study Matters

The Swedish research represents a significant advancement in our understanding because:

1. Massive scale: Nearly 2.5 million children provided unprecedented statistical power

2. Long-term follow-up: Up to 26 years of monitoring ensured comprehensive outcome assessment

3. Sibling controls: This sophisticated methodology eliminates confounding factors that plagued earlier studies

4. Real-world data: Used comprehensive health registry data rather than self-reported information

What the TGA Says

The Australian Therapeutic Goods Administration has clearly stated:

Paracetamol remains the recommended treatment option for pain or fever in pregnant women when used as directed
The TGA maintains robust post-market safety surveillance for all medicines, including paracetamol
No active safety investigations are currently underway for paracetamol and autism or neurodevelopmental disorders
Any new evidence that could affect recommendations would be carefully evaluated by independent scientific experts

The Importance of Treating Fever and Pain

It's crucial to understand that untreated fever during pregnancy poses significant risks to both mother and developing baby. Fever has been linked to adverse pregnancy outcomes, including neurodevelopmental disorders. This makes appropriate pain and fever management during pregnancy not just beneficial, but essential for optimal maternal and fetal health.

What the TGA Says

If you're pregnant and considering paracetamol use, here's what healthcare professionals recommend:

Assessment and Consultation

Individual assessment is key - your symptoms, health history, other medications, and pregnancy circumstances all matter
Discuss with your pharmacist or doctor any concerns about medication use during pregnancy
Access current, evidence-based information from reliable healthcare sources

Responsible Use Guidelines

Use only when needed according to package instructions
Follow dosing guidelines and use for the shortest duration necessary
Consider non-medication approaches such as staying hydrated, using cold compresses, and adequate rest
Seek expert advice when more specialized care may be needed

When to Seek Professional Guidance

If you have concerns about any medication during pregnancy
When symptoms are severe or persistent
If you have underlying health conditions
When multiple medications are being considered

The Bigger Picture on Autism

Understanding autism requires looking beyond single factors. Research consistently shows that autism has:

Strong genetic components - siblings of autistic children have a 20% likelihood of also being diagnosed
Multiple contributing factors - no single cause has been identified
Complex developmental patterns - early intervention and support make significant differences in outcomes

Moving Forward with Confidence

The weight of scientific evidence, including the most comprehensive and methodologically sound studies available, supports the continued safe use of paracetamol during pregnancy when clinically appropriate. The TGA's Pregnancy Category A classification reflects decades of safety data and ongoing monitoring.

Key takeaways for expectant mothers:

1. Paracetamol remains safe and effective for managing pain and fever during pregnancy

2. The benefits of treating fever and pain outweigh theoretical risks suggested by flawed studies

3. Individual consultation with healthcare professionals ensures personalized care

4. Evidence-based decision making should guide medication choices during pregnancy

Stay Informed with Reliable Sources

Healthcare guidance should always be based on the best available scientific evidence. We encourage expectant mothers to:

Consult with qualified healthcare professionals
Rely on evidence from peer-reviewed research
Consider guidance from established regulatory bodies like the TGA
Avoid making medication decisions based on incomplete or misleading information

At SuperPharmacyPlus, we're committed to providing you with accurate, up-to-date health information. Our pharmacists are always available to discuss your medication concerns and help you make informed decisions about your health during pregnancy and beyond.

For personalized advice about medication use during pregnancy, speak with our qualified pharmacists or consult your healthcare provider. We're here to support you with evidence-based guidance for your health journey.

References:

Ahlqvist, V.H., et al. (2024). Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability. JAMA.
Therapeutic Goods Administration (2025). Paracetamol use in pregnancy.
Australian Government Department of Health guidelines on pregnancy medication safety