Taking paracetamol while pregnant is safe and there's no evidence it raises the risk of autism, ADHD and developmental issues in children, say experts behind a major new review.
Pregnant women should feel reassured by the findings, which contradict controversial claims from US President Donald Trump last year that paracetamol is no good and pregnant women should fight like hell not to take it.
His views were criticized at the time by medical organizations worldwide. Experts say this latest review, published in The Lancet journal, is rigorous and should end the debate over its safety.
But US health officials maintain that many experts have expressed concern over its use during pregnancy.
The US President shocked many doctors worldwide when he and his administration claimed paracetamol or a branded version called Tylenol - which is seen as the go-to painkiller for pregnant women - could be linked to autism in children, if taken during pregnancy.
Those claims led to confusion among women and concern among health experts, prompting this new research.
Published in The Lancet Obstetrics, Gynaecology & Women's Health, it looked at 43 of the most robust studies into paracetamol use during pregnancy, involving hundreds of thousands of women, particularly those comparing pregnancies where the mother had taken the drug to pregnancies where she hadn't.
The researchers say using these high-quality studies of siblings allows them to dismiss other factors such as different genes and family environments, making their review gold-standard.
The research examined studies with a low risk of bias and those that followed children for more than five years to check for any link.
When we did this analysis, we found no links; there was no association; there's no evidence that paracetamol increases the risk of autism, said lead study author Professor Asma Khalil.
The message is clear – paracetamol remains a safe option during pregnancy when taken as guided, she added.
This reinforces guidance from major medical organizations in the UK, US and Europe on the safety of the common painkiller.
Any previously-reported links between the drug and an increased risk of autism are likely to be explained by other factors, rather than a direct effect of the paracetamol itself, the review states.
This is crucial as paracetamol is the first-line medication recommended for pregnant women in pain or with a fever, said Professor Khalil.
Medical experts not involved in the research have welcomed the study's findings, saying it will help reduce worry among women.
Prof Grainne McAlonnan, from King's College London, said expectant mothers do not need the stress of questioning whether medicine most commonly used for a headache could have far-reaching effects on their child's health.
Prof Ian Douglas, from the London School of Hygiene and Tropical Medicine, noted the review was well-conducted because it excluded studies of lower quality.
According to Prof Jan Haavik, from the University of Bergen, the study provides strong evidence that use of paracetamol during pregnancy does not increase the risk of autism, ADHD or intellectual disability and should effectively put this question to rest.
A spokesman from the US Department of Health and Human Services emphasized that many experts have expressed concern over acetaminophen use during pregnancy. A review led by Dr. Andrew Baccarelli found potential risk factors, urging caution regarding heavy or prolonged use.
