Taking paracetamol during pregnancy is safe and there is no evidence that it increases the risk of autism, ADHD and developmental problems in children, say experts behind a major new study.
Pregnant women "should feel reassured" by the findings, they explain.
This research contradicts controversial claims by US President Donald Trump that paracetamol is "not good" and that pregnant women should "fight like hell" not to take it.
His views were criticized at the time by medical organizations around the world.
Experts say the latest research, published in the journal The Lancet, should end the debate over the drug's safety.
But US health officials say "many experts" have expressed concerns about its use during pregnancy.
The US president shocked many doctors around the world when he said that paracetamol, known as acetaminophen in the US, which is considered the most effective painkiller for pregnant women - could be linked to autism in children if taken during pregnancy.
Those claims have led to confusion among women and concern among health experts, and prompted this new research.
Published in a magazine The Lancet Obstetrics, Gynecology & Women's Health The research included 43 studies on the use of paracetamol during pregnancy, involving hundreds of thousands of women, particularly those that compared pregnancies in which the mother took the drug with pregnancies in which she did not take it.
The research also included studies with a low risk of bias and those that followed children for more than five years to check if there was any link.
"When we did this analysis, we found no association, no evidence that paracetamol increases the risk of autism," Professor Asma Kalil, the study's author, told the BBC.
"The message is clear, paracetamol remains a safe option during pregnancy when taken as directed," she added.
This confirms guidelines from major medical organisations in the UK, US and Europe on the safety of this common painkiller.
All previously reported links between the drug and increased risk of autism can probably be explained by factors other than a direct effect of paracetamol itself, the review said.
"This is important because paracetamol is the first-line drug we recommend for pregnant women with pain or fever," said Khalil, a professor of medicine at St George's University, London.
Women may risk harming their baby if they do not take paracetamol to reduce high fever or relieve pain during pregnancy.
This can further increase the risk of miscarriage, premature birth or developmental problems in babies, experts believe.
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The study findings will help reduce concerns among women, said medical experts who were not involved in the research.
Expectant mothers "should not stress themselves out by wondering whether the most commonly used headache medications could have far-reaching consequences for their child's health," said Grainne McAlonnan, a professor at King's College London.
"I hope the findings of this study will bring the matter to a close," she added.
Ian Douglas of the London School of Hygiene and Tropical Medicine said the review was "well conducted" because it excluded lower quality studies.
Scientists working in this field are convinced that autism is the result of a complex mix of causes, such as genetic and environmental factors.
A Health Department spokesman said "many experts" had expressed concerns about the use of acetaminophen - the American name for paracetamol. during pregnancy.
For example, an August 2025 review led by Andrew Baccarelli, dean of the Harvard T.H. Chan School of Public Health, found that acetaminophen use during pregnancy may increase the risk of autism and ADHD in children, and urged caution with "excessive or prolonged use."
Months earlier, Secretary of Health and Human Services Robert F. Kennedy Jr. had promised to find the cause of the sharp increase in reported cases of autism.
In a controversial Oval Office speech in September, the US president said doctors would be advised not to prescribe the painkiller to pregnant women.
The US Food and Drug Administration (FDA) then issued a letter to doctors urging them to be cautious about using acetaminophen during pregnancy, while also saying that it remains the only drug approved to treat fever during pregnancy.
On the website, FDA explains that a "causal relationship" between the drug and neurological conditions "has not been established."
Paracetamol is the safest painkiller available to pregnant women, officials in the UK have announced.
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