NSAIDS during pregnancy and miscarriage risk

In a study funded by the Canadian health ministry (analogous to the US FDA), researchers found a 2.4 fold increased risk of miscarriage in women who used prescription Non-steroidal anti-inflammatory Drugs, commonly known as NSAIDS. The study was reported in the Canadian Medical Association Journal.

Their conclusion is that non-aspirin NSAIDS should be used with caution in pregnancy. The researchers note that this is probably a class effect, meaning that prescription or non-prescription non-aspirin NSAIDS can cause the problem.

It’s important to take a closer look at this.

The medicines studied include:

Ibuprofen,  naproxen, diclofenac, and celecoxib (Celebrex) and French and Canadian researchers evaluated 4,705 miscarriages as far along as up to the 20th week of pregnancy. The women studied were 15 to 45. The greatest risk for miscarriage was found in the women who had taken diclofenac. To further complex this issue, more women who had miscarriage had other illnesses in the year before pregnancy, tended to be slightly older, received social assistance and lived in cities. The group studied covered about 36% of the population, which could affect how well the findings could be generalized to the total population.

It’s also important to notice that NSAIDS are also available without a prescription for some of the women in the study area. This means that the study results probably underreported exposure to NSAIDS.

The lead researcher, Anik Bernard from the University of Montreal and fellow researchers looked at information from hospital and drug data bases in Quebec and also had access to a registry of all pregnancies in the province since 1997. A 2003 study from the British Medical Journal found an 80 % increased risk from NSAIDS although the study design was later found to be flawed.

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