Common anti-inflammatory drugs like ibuprofen and naproxen may increase the risk of miscarriage if taken in early pregnancy, according to the results of a new study published in the Canadian Medical Association Journal.
The risk of miscarriage more than doubled in women who were exposed to any non-steroidal anti-inflammatory drugs (NSAIDs) during the first 20 weeks of pregnancy, according to Canadian researchers who studied health records from almost 50,000 Canadian women between the ages of 15 and 45. NSAID exposure was defined as at least one filled prescription for non-aspirin NSAIDs after the start of pregnancy or a prescription filled before but overlapping with pregnancy (most NSAIDs in Canada are prescription-only instead of OTC, like they are in the U.S.). The researchers could not confirm that women had actually taken the medication, though. There was no association found between miscarriage and NSAID dosage, although women who took the drug diclofenac at the highest risk of miscarriage, while women who took rofecoxib had the lowest.
Although the use of non-aspirin NSAIDs during early pregnancy had already been shown to increase the risk of major congenital malformations, up to 17 percent of pregnant women still take the drugs, either in prescription or over-the-counter formulations (including brand names like Advil, Motrin and Aleve; check out PubMed for a complete list of brand names for ibuprofen and naproxen in the U.S.). The study’s authors cautioned against any use of these drugs in early pregnancy.
The researchers accounted for other factors that might increase the chance of miscarriage, like high blood pressure, rheumatoid arthritis, heart disease, diabetes, asthma, lupus, depression and anxiety, when calculating the risk associated with NSAID use. Ultimately they found that the rate of miscarriage in women who took prescription NSAIDs in early pregnancy was about 35 percent, compared to the normal rate of miscarriage, around 15 percent.
But, while the study results do sound scary, they are not reason to freak out. Dr. Laura Riley, an ob-gyn at Massachusetts General Hospital in Boston and author of You & Your Baby: Pregnancy, told us, “In general, the data from the study mostly suggests that there could be an increased risk of miscarriage. With drugs in pregnancy in general, there haven’t been that many studies of the side effects, which is why doctors recommend being very judicious in making those kinds of choices.”
If you’re suffering from a headache or similar pain that might lead you to reach for a bottle of OTC pain relievers in your non-pregnant state, Dr. Riley suggests checking in with your doctor before taking any medicine, if you have the opportunity. “Tylenol is about the only medication that we say, ‘Don’t worry about it,’” she adds. Ultimately, “If you can avoid [taking NSAIDs during pregnancy], avoid it. If you’ve already taken it, don’t panic. But, as you go forward through the pregnancy, I would check with somebody before taking any other drugs, as they may not necessarily have been studied during pregnancy.”
Finally, for women who have preexisting medical conditions for which they take NSAIDs, Dr. Riley suggests, “Always check with your care provider first to see if you should remain on that medication or transition to something else. You don’t want to just stop medication because sometimes the risk of stopping the medication and having the disease progress is worse than the potential risk to yourself or your fetus from taking the drug.”
Did you take any ibuprofen or naproxen during pregnancy, or did you stick with acetaminophen or another remedy?