NSAIDs May Increase Risk of Miscarriage

NSAIDs May Increase Risk of Miscarriage

A new study, published in the journal American Journal of Obstetrics & Gynecology, shows that using non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, around the time of conception and in pregnancy may increase the risk of early miscarriage.

The study was conducted at Kaiser Permanente Northern California and included over 1,000 pregnant women.  Researcher followed 241 women who took only NSAIDs around the time of conception and during the first 20 weeks of pregnancy, 391 women who took only acetaminophen during this time, and 465 women who took neither type of medication.

Even after controlling for maternal age, history of previous miscarriage, multivitamin use, caffeine intake, and smoking during pregnancy, it was found that women who used NSAIDs had a significantly increased risk of miscarriage compared to women in the other 2 groups.  When NSAIDs were used around the time of conception, there was a more than four-fold higher risk of early miscarriage.  Of note, women with lower body mass index (BMI <25) appeared to be more susceptible to the effect of NSAID use around the time of conception compared to women with higher BMIs.

In the past year, multiple studies have shown that ibuprofen use in early pregnancy has risks.  For instance, another recent study in the journal Human Reproduction, suggested that if ibuprofen is taken by a woman early in pregnancy, it may affect her daughter’s future fertility.  The study showed that if a woman is pregnant with a female embryo and takes ibuprofen in the first 3 months of pregnancy, it might reduce the number of eggs that her daughter is born with.

Obstetricians have always cautioned patients to avoid ibuprofen use in pregnancy if possible and these studies provide more evidence to continue to do so.  Pregnant women needing pain medication should discuss the risks and benefits with their physicians.  In addition, women trying to conceive should be mindful of these recommendations starting from the time of ovulation.  In general, pain medication should be taken only when necessary, at the lowest doses, and for the shortest time possible.

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