Paracetamol, known as acetaminophen in the United States and widely sold under brand names like Tylenol, is a staple in medicine cabinets worldwide. Its reputation as a safe, go-to remedy for pain, headaches, and fever—especially during pregnancy—has rarely been questioned. But a new wave of research led by scientists from Mount Sinai Hospital and Harvard’s School of Public Health is prompting a serious rethink. On August 22, 2025, these experts issued a stark warning: pregnant women should only take paracetamol on the advice of a doctor, as mounting evidence suggests a link between prenatal use of the drug and increased risks of autism and ADHD in children.
The findings, published in the journal Environmental Health, are the culmination of an exhaustive review of 46 separate studies involving more than 100,000 participants. According to the researchers, this is the most comprehensive analysis to date and offers what they call the “strongest evidence so far” of a connection between paracetamol use during pregnancy and neurodevelopmental disorders. Dr. Diddier Prada, assistant professor of population health science at Mount Sinai Hospital and a co-author of the study, didn’t mince words: “Our findings show that higher-quality studies are more likely to show a link between prenatal acetaminophen exposure and increased risks of autism and ADHD.”
That’s a sobering statement, especially considering just how common paracetamol use is among expectant mothers. Data show that around half of pregnant women in the UK and about 65 percent in the US take the drug at some point during pregnancy. The NHS currently recommends paracetamol as the first-choice painkiller for pregnant women, but even they advise using the lowest effective dose for the shortest possible time. It’s the same story across the Atlantic, where acetaminophen is often considered the safest option for managing discomfort during pregnancy.
But the new research is urging a more cautious approach. The scientists recommend that pregnant women use paracetamol sparingly and only after consulting their healthcare provider. “Given the widespread use of this medication, even a small increase in risk could have major public health implications,” Dr. Prada emphasized. He also cautioned against panic or abrupt changes in medication: “Pregnant women should not stop taking medication without consulting their doctors. Untreated pain or fever can also harm the baby. Our study highlights the importance of discussing the safest approach with health care providers and considering non-drug options whenever possible.”
The study’s methodology was rigorous. The team collected detailed data on when paracetamol was taken—whether in the first, second, or third trimester, or throughout the entire pregnancy—and linked this information with mothers’ medical records. They then assessed the quality of the studies and the strength of the associations reported. In their words, “Ultimately, the obtained scores suggest strong evidence of a likely relationship between prenatal acetaminophen use and increased risk of ADHD in children. This includes high-quality studies that provide very strong evidence of an association and studies that provide strong evidence of an association.” They went on to add, “There was strong evidence of a relationship between prenatal acetaminophen use and increased risk of autism in children.”
It’s important to note, however, that the researchers stopped short of declaring a direct cause-and-effect relationship. Instead, they described the association as “consistent and worrying enough to demand further investigation.” In other words, while the evidence is mounting, more research is needed to understand exactly how paracetamol might influence neurodevelopment and whether other factors could be at play.
The implications of these findings are particularly pressing given the current state of autism and ADHD diagnoses. According to NHS figures from December 2024, nearly 130,000 under-18s in England were waiting for an autism assessment. Experts have described the situation as an “invisible crisis,” with services struggling to keep up with soaring demand. The Children’s Commissioner has warned that children languishing on waiting lists are effectively being “robbed” of their childhoods.
Meanwhile, the number of people prescribed ADHD medication in England has surged to more than 230,000, with prescription rates jumping by 20 percent in the previous year alone—the sharpest annual rise since records began in 2015. The increase isn’t limited to children; women in their 20s and 30s are now driving much of the growth in prescriptions. This shift reflects a broader recognition that ADHD is not just a childhood disorder—something the UK only formally acknowledged in 2008. Before then, ADHD was largely seen as a problem that children would “grow out of.”
The trend is similar in the United States. The Centers for Disease Control and Prevention (CDC) reports that the prevalence of autism spectrum disorder (ASD) has risen dramatically over the past two decades. In 2000, about 1 in 150 children received an ASD diagnosis. By 2020, that figure had soared to 1 in 31—a near-quadrupling that experts attribute to a combination of increased awareness, broader diagnostic criteria, and possibly other environmental or biological factors. A 2024 study analyzing the health records of 12.2 million Americans found a staggering 175 percent increase in autism diagnoses over an 11-year period.
This surge in diagnoses has sparked debate among researchers and clinicians. Some argue that the rise is primarily due to expanded screening, reduced stigma, and better access to diagnostic services. Others suggest that environmental factors—including potential exposures during pregnancy—could also be contributing. The new research linking paracetamol use to increased risks of autism and ADHD adds another layer to this complex discussion.
Of course, paracetamol is not without its benefits. For many pregnant women, it remains the only viable option for managing pain or fever, especially when other medications are off-limits. Health authorities, including the NHS, continue to recommend its use—albeit with caution. They stress that only certain people, such as those with liver or kidney disease or those taking epilepsy medication, need to exercise extra vigilance. The key message is balance: don’t stop taking prescribed medication without consulting a doctor, but do weigh the risks and benefits carefully, ideally with professional guidance.
As the debate continues, one thing is clear: the conversation around paracetamol use in pregnancy is far from over. The latest research from Mount Sinai and Harvard’s School of Public Health has added significant weight to calls for more careful prescribing and monitoring. For expectant mothers, the advice is straightforward but crucial—use paracetamol only when necessary, at the lowest effective dose, and always in consultation with a healthcare provider. The hope is that with greater awareness and more research, both mothers and children can stay safe and healthy in the years to come.
