NSAIDs Like Ibuprofen Do Not Increase Risk of Miscarriage

Advil on DeskNonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB) and naproxen (Aleve) are increasingly used by pregnant women to treat pain, fever, and inflammation during the first trimester of pregnancy. Now a new study published in CMAJ (Canadian Medical Association Journal) confirms that women who use NSAIDS during pregnancy do not have an increased risk of miscarriages.

Explains senior study author Amalia Levy, an epidemiologist and head of the department of public health at Ben-Gurion University of the Negev in Beersheba, “NSAIDs are frequently and increasingly used by pregnant women both because the drugs are indicated for common symptoms like pain and fever, and because in the past two decades some of the drugs are sold over the counter, without the need for a medical prescription.”

To study the relationship between NSAIDs and miscarriage risk, the researchers analyzed data on 65,457 women between the ages of 15 and 45 years old who were admitted to Soroka Medical Center in Beer-Sheva, Israel between January 2003 and December 2009 to give birth or for a miscarriage. Ninety percent of the women were admitted to give birth while 10 percent were admitted for a miscarriage.

Of the total women in the study, 4,495 (6.9 percent) used NSAIDs during the first trimester of pregnancy.

Of the total women who took general anti-inflammatories, 8.2 percent experienced a miscarriage. Of the women who did not use the medication, 10 percent experienced a miscarriage.

In other words, the use of general NSAIDs like ibuprofen during the first trimester of pregnancy does not appear to increase the risk of miscarriage.

However, 17 percent of women who took COX-2 selective inhibitors, drugs that target specific inflammation, experienced a miscarriage. However, the percentage was low and warrants additional research. The researchers also note that COX-2 selective inhibitors like indomethacin are often used to treat preterm labor and that the average daily doses of indomethacin were higher than for other NSAIDs. Both factors could explain the increased risk of miscarriage associated with COX-2 selective inhibitors.

States lead author Dr. Sharon Daniel, a pediatric intern at Soroka Medical Center, in Beersheba, Israel, “We did not find an increased risk of miscarriage among women who took those drugs during the first trimester of pregnancy, although we did find an increased risk after the use of indomethacin.”

Concludes Prof. Amalia Levy, Department of Public Health, Ben-Gurion University of the Negev and Soroka Medical Center, “The fact that the study was based on large proportion of the district population, was adjusted to nearly all known risk factors for miscarriages (tobacco use, obesity, IVF, uterine malformations, hypercoagulable conditions, intrauterine contraceptive device etc.) and used advanced statistical methods strengthens the validity of the results.”


NSAIDs Won’t Raise Miscarriage Risk: Study:
Risk of Miscarriages Not Increased by NSAIDs:

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