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Anti-Inflammatory Drugs and Miscarriage Risk

December 3, 2011 by  
Filed under R.McAllister

Taking Anti-Inflammatory Drugs in Early Pregnancy Doubles the Risk of Miscarriage
By Rallie McAllister, MD, MPH

Pregnancy has its fair share of aches and pains, but taking anti-inflammatory drugs while you’re expecting isn’t the best way to deal with your discomfort. According to a new study* published in the Canadian Medical Association Journal, anti-inflammatory drugs taken in early pregnancy more than doubles the risk of miscarriage. The researchers found that the risk of miscarriage was 2.4 times greater for women who took any type and dosage of non-aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) in early pregnancy.

Non-aspirin NSAIDs comprise a class of drugs that includes naproxen, ibuprofen, diclofenac, and celecoxib, and these are some of the most common medications used during pregnancy. In recent years, physicians have expressed concerns about the use of these drugs by pregnant women, although the results of previous studies examining the risks have been inconsistent.

Canadian and French researchers designed a new study to determine the risk of miscarriage associated with the types and dosages of non-aspirin NSAIDs, examining a total of 4,705 cases of miscarriage up to the 20th week of gestation. Of these miscarriages, 352 (7.5 percent) occurred in women who took non-aspirin NSAIDs. Of the 47,050 women in the control group who did not suffer a miscarriage, 1,213 (2.6 percent) were exposed to non-aspirin NSAIDs. Exposure to non-aspirin NSAIDs was defined as having filled at least one prescription for any type of the drug during the first 20 weeks of pregnancy or in the two weeks prior to the beginning of the pregnancy.

The researchers concluded that the use of non-aspirin NSAIDs during early pregnancy is associated with significant risk (2.4-fold increase) of having a spontaneous abortion. Dosage of non-aspirin NSAIDs did not appear to affect the risk. Earlier studies indicate that the use of non-aspirin NSAIDs during early pregnancy also increases the risk of major congenital malformations in infants. With this in mind, non-aspirin NSAIDs should be used with caution during pregnancy.

If you’re pregnant and you’re suffering from minor aches and pains, talk to your doctor about other ways to deal with your discomfort.

*Hamid Reza Nakhai-Pour, Perrine Broy, Odile Sheehy, and Anick Bérard. Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion. CMAJ, September 6, 2011 DOI: 10.1503/cmaj.110454


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