MAM endorses statements by Superintendent of Public Health and MCOG: Paracetamol remains safe in pregnancy

The Medical Association of Malta (MAM) expresses its full support for the position taken by the Superintendent of Public Health and the Malta College of Obstetricians and Gynaecologists (MCOG) regarding the safety of paracetamol (acetaminophen) use during pregnancy.

Local Clarification and Reassurance

Following recent international media reports — including unfounded claims made by U.S. President Donald Trump — questions have been raised regarding paracetamol’s safety in pregnancy.

In response, Malta’s Superintendent of Public Health has publicly reassured the public, stating:

“Current scientific evidence does not support a causal link between paracetamol use in pregnancy and autism in children. Paracetamol remains an appropriate first-line option for relief of pain and fever during pregnancy, when used at the lowest effective dose and for the shortest necessary duration.” (Times of Malta, 23.09.2025)

The Superintendent’s office also emphasised that pregnant individuals should not stop or withhold treatment without consulting their doctor, as untreated fever or significant pain can itself pose risks to both mother and baby. Pregnant patients are encouraged to raise any questions about medications directly with their healthcare professional.

The Malta College of Obstetricians and Gynaecologists (MCOG), in a parallel statement, confirmed:

“Our recommendation based on review of international literature and guidelines is that paracetamol is the safest medication for the control of pain and fever in pregnancy. Its use, like with all medications in pregnancy, should be under medical advice and it should be taken at the lowest effective dose and for the shortest duration.”

MAM fully endorses both of these local statements.

Global Evidence and Expert Consensus

The joint Maltese position is fully consistent with international scientific guidance:

UK (MHRA, 23.09.2025): Confirms that there is no evidence paracetamol taken in pregnancy causes autism, and continues to support its use as safe.

Royal College of Obstetricians and Gynaecologists (UK): States paracetamol remains the recommended option for pregnant women for pain and fever when used as directed.

Australia (Chief Medical Officer and TGA): Explicitly rejects claims linking paracetamol to ADHD or autism; maintains it is the preferred treatment for pain or fever in pregnancy.

Canada (SOGC): Supports acetaminophen use in pregnancy only when medically necessary, and always at the lowest effective dose for the shortest possible time.

USA (American College of Obstetricians and Gynaecologists, 22.09.2025): Confirms paracetamol is the first-choice medication for pain and fever in pregnancy. ACOG also criticised the release of speculative statements without reliable data, warning that this could harm pregnant people and their babies by discouraging safe treatment.

European Medicines Agency (EMA): Confirms no change to EU recommendations — paracetamol remains safe to use in pregnancy when clinically indicated, with no new evidence to suggest otherwise.

Why This Matters

Uncontrolled pain and fever in pregnancy are not trivial — they can lead to complications such as:

• Premature labour,
• Low birth weight,
• Reduced oxygen supply to the baby, and
• In extreme cases, miscarriage or stillbirth.

Paracetamol is widely regarded as the safest and most effective first-line option available, with decades of clinical data supporting its use in pregnancy. By contrast, alternatives such as non-steroidal anti-inflammatory drugs (NSAIDs) carry well-documented risks, particularly in later pregnancy (including kidney and heart complications in the foetus).

MAM’s Position

1. Unified Support: MAM supports both the Superintendent of Public Health and MCOG in their clear and evidence-based reassurances to the public.
2. Reassurance: Paracetamol remains the recommended first-line treatment for pain and fever in pregnancy, when used appropriately.
3. Safety First: Pregnant individuals should not stop necessary treatment based on speculative media reports. Always seek medical advice before starting, adjusting, or stopping any medication.
4. Scientific Vigilance: MAM will continue to monitor emerging evidence, but stresses that current international guidance remains unanimous in affirming the safety of paracetamol in pregnancy.
5. Public Confidence: Misleading or unverified claims risk undermining maternal and child health by causing hesitation in the use of safe and effective treatment.

Conclusion

MAM stands firmly with Malta’s public health authorities and the MCOG in reassuring the public:
paracetamol remains safe, effective, and appropriate for use during pregnancy when taken as directed.