Study: Anti-inflammatory during Pregnancy – What’s the Risk?
These “painkillers” are often used during pregnancy – but they may significantly increase the danger of miscarriage.
This study is quite a few months old now, but it’s worth taking a look at. The study, published in the CMAJ (Canadian Medical Association Journal), looked at nonsteroidal anti-inflammatory drugs (NSAIDs). This would include ibuprofen (ie Advil, Motrin), naproxen (ie Aleve, Treximet), and celecoxib (Celebrex).
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The summary from the CMAJ was this:
The risk of miscarriage is 2.4 times greater for women who took any type and dosage of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) in early pregnancy, according to a study in CMAJ(Canadian Medical Association Journal).
“The use of nonaspirin NSAIDs during early pregnancy is associated with statistically significant risk (2.4-fold increase) of having a spontaneous abortion,” writes Dr. Anick Bérard, from the University of Montreal and the Director of the Research Unit on Medications and Pregnancy at CHU Ste-Justine. “We consistently saw that the risk of having a spontaneous abortion was associated with gestational use of diclofenac, naproxen, celecoxib, ibuprofen and rofecoxib alone or in combination, suggesting a class effect.”
Researchers made some interesting notes about this study. First, studies are not entirely consistent. This isn’t unusual, but it does indicate that further study is needed.
One of the possible reasons for the inconsistency is that some women may be taking NSAIDs for cramps that come before a miscarriage – in other words, other problems were already to blame, not the NSAIDs themselves.
That being said, in this study there did not seem to be a difference between taking the medication eary in the pregnancy and long before the miscarriage or right before the miscarriage.
Strengthening the case further, other studies have shown the same thing, and have also shown an increased risk of birth defects (congenital malformations).
Second, dosage didn’t seem to matter. In other words, this isn’t only a danger for women taking especially high dosages.
However, researchers did think that the greatest danger was around the time of conception. This study focused on women who took NSAIDs around the time of conception up to 20 weeks.
So what can we learn from this study, and where do we go from here?
- There is a significant risk to taking NSAIDs such as ibuprofen and naproxen during pregnancy. This is a risk that varies from NSAID to NSAID and from person to person. You need to talk with a doctor who knows your medical history – not simply buy something over the counter and take it.
- There may be a higher risk earlier in the pregnancy. That doesn’t mean you should take the medications later on – it does mean that we need to research the reasons why this may be. In this study, the researchers suggested some possibilities. If we can confirm this and measure the risk, we may be able to get medications to women who are at low risk.
For more about taking drugs during pregnancy, particularly in the case of migraine, read Can Pregnant Migraineurs Take Drugs?
If you’d like to know more about this study – its methods and limitations, here are some resources: