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NSAIDs are a Big Risk for Pregnancy



Women who are considering pregnancy and those already in their first trimester of pregnancy should be warned that taking non-steroidal anti-inflammatory drugs (NSAIDs) may increase their risk for miscarriage. Physicians already deter the use of NSAIDs in the last trimester of pregnancy because it can interfere with the healthy development of fetal circulation.


“I would strongly suggest that women take no non-steroidal anti-inflammatory drugs during the first trimester”   Anick Berard


“If a woman is taking an NSAID for a chronic condition she really has to talk to her health care provider to see if it’s feasible to stop at least during the first trimester.”


“Gestational exposure to any type or dosage of non-aspirin NSAIDs may increase risk of spontaneous abortion. These drugs should be used with caution during pregnancy.”


In 2011, a group of Canadian and French researchers conducted a study for women in their first trimester who were between the ages of 15 and 45.  They analyzed over 55,000 women in which 4,700 suffered a miscarriage and compared those to the control group who did not. The studies unveiled that 7.5% of the women who suffered a miscarriage in the beginning weeks of their pregnancy had filled at least one prescription for an NSAID.  The researchers considered anyone in the study to be using NSAIDs if they had filled at least one prescription just before pregnancy or within the 20 weeks after conception. Specifically named drugs had differing risks associated with them. Diclofenac, which is used to treat pain and inflammatory disorders and is commonly given to arthritis patients, tripled the risk of miscarriage, naproxen (Aleve), increased the risk by 2.64 times, and ibprofen (Advil, Motrin) doubled the risk. 


No one is certain how NSAIDs might cause miscarriage but researchers have a theory that the NSAIDs might interfere with levels of the hormones called prostaglandins, which are involved in inducing labor. In pregnancy, prostaglandins decrease in the uterus in a consistent way, but it is quite possible that the NSAIDs cause these levels to fluctuate Anick Berard, director of the research unit on medications and pregnancy at Centre Hospitalier Universitaire Ste. Justine, suggests. For pregnant women who are experiencing pain during pregnancy, Berard, suggests they avoid NSAIDs and turn to acetaminophen which is considered a safe alternative during the early stages of pregnancy.  For women with conditions such as rheumatoid arthritis or lupus she says it is better to plan the pregnancy and discuss alternative treatments with a doctor beforehand.