NSAID Risks in Early Pregnancy Studied

NSAID Risks in Early Pregnancy Studied

As reported in MedPage Today, a new study of the risks of nonsteroidal antiinflammatory drugs (NSAIDs) in pregnancy has been published in the American Journal of Obstetrics and Gynecology.  NSAIDS are commonly used by pregnant women, despite previous research showing a higher risk of miscarriage associated with their use.  The new study analyzed data on NSAID use by pregnant women who are members of the Kaiser Permanente healthcare system.  The investigators compared those to reported NSAID use, acetaminophen use or neither around conception.

NSAID use during pregnancy was associated with a significantly (59%) increased risk of miscarriage compared with unexposed controls (adjusted hazard ratio (HR), 1.59; 95% confidence interval, 1.13-2.24) or a 45% increased risk in those exposed to acetaminophen (adjusted HR, 1.45, 95% confidence interval, 1.01-2.08).  Nearly one-quarter of the women who took NSAIDs had miscarriages within the first 20 weeks of pregnancy, compared with 16% of those who took acetaminophen and 17% of women who took neither medication.

Current warnings regarding NSAID use in pregnancy are primarily focused on avoiding use after gestational week 32 to prevent premature closure of the ductus arteriosus.  Previous research on risks earlier in pregnancy has been mixed.  Although the findings have not always been consistent, the proposed mechanism for the association between NSAID use and miscarriage focuses on the inhibition of prostaglandin synthesis, which is essential for successful embryonic implantation.

Additional information about many NSAIDs, including ibuprofen and naproxen can be found in the Top 300 Pharmacy Drug Cards.  If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to the Top 300 Pharmacy Drug Cards.  If your institution does not provide access, ask your medical librarian about subscribing.

For more information…

 Click here for a report from MedPage Today.

The full study can also be found online:

Li D-K, Ferber JR, Odouli R, et al. Use of nonsteroidal antiinflammatory drugs during pregnancy and the risk of miscarriage. Am J Obstet Gynecol; 2018.