Use of NSAIDs, Greater Risk for Miscarriage

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The use of common NSAIDs or non-steroidal anti-inflammatory drugs like ibuprofen and naproxen during the first five months of pregnancy may increase the risk for miscarriage. The risk for termination of pregnancy is deemed to double if taken during the first twenty weeks of gestation, says researchers who made use of health records of nearly 50,000 Canadian women. The said study is also published in the Canadian Medical Association Journal.

According to Anick Berard, one of the co-authors of the research, the use of NSAIDs is very common and an earlier study found out that up to 17% of pregnant women make use of NSAIDs either as prescription drugs or over-the-counter medications. This newer study made use of more specific non-aspirin NSAIDs like naproxen, ibuprofen and the like.

“I would strongly suggest that women take no non-steroidal anti-inflammatory drugs during the first trimester… 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,” said Berard who is also a professor of epidemiology at the University of Montreal and director of the research unit on medications and pregnancy at Centre Hospitalier Universitaire Ste. Justine.

In their study, the researchers made use of medical records of about 4,705 pregnant women who had a miscarriage during the first five months of gestation. Women were 15-45 years old. Out of these women, 352 women made use of NSAIDs. 1213 of the women who made use of NSAIDs did not experience pregnancy loss.

In considering these risks, the researchers accounted for other factors which might lead to miscarriage like diabetes mellitus, high blood pressure, asthma, lupus, rheumatoid arthritis, depression, anxiety and heart diseases. With all these facts in account, it was concluded that pregnant women taking NSAIDs were 2.4 times more likely to experience termination of pregnancy. The rate for miscarriage among them is 35% than those not taking NSAIDs which recorded about 15%.

The authors of the study hypothesized that this increased risk for miscarriage is due to the effect of NSAIDs in the prostaglandin levels of women. In normal situations, prostaglandin levels in the uterus gradually decreases. However, for pregnant women taking NSAIDs, the prostaglandin levels may tend to fluctuate.

Furthermore, Berard said that “We cannot say for 100 percent sure that this is a true drug effect. But we’re one step closer to proving causality when there is repetition of the finding. And there is at least one other study looking at this specifically that found an increased risk.”

 

According to the American Pregnancy Organization, For women in childbearing years, the chances of having a miscarriage can range from 10-25%, and in most healthy women the average is about a 15-20% chance.

  • An increase in maternal age affects the chances of miscarriage
  • Women under the age of 35 yrs old have about a 15% chance of miscarriage
  • Women who are 35-45 yrs old have a 20-35% chance of miscarriage

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