Warning to Pregnant Women on Use of Ibuprofen

A recent study has claimed that women who take even small doses of painkillers, such as ibuprofen, early on in their pregnancy are two times more at a risk of suffering a miscarriage. The research which was published in the Canadian Medical Association Journal, revealed that pregnant women consuming any form or dose of NSAIDs (Non-steroidal anti-inflammatory drugs) during the first 20 weeks of pregnancy increased their risk of spontaneous abortion by 2.4 times.

NSAIDs (Non-steroidal anti-inflammatory drugs) are a class of medicines that include painkillers such as ibuprofen, naproxen and Diclofenac. According to the recently published study, if a pregnant woman consumes painkillers that belong to the category of NSAIDs during the first 20 weeks of pregnancy, it increases her risk of miscarriage by 2.4 timesThe findings prompted doctors to advise pregnant women to stay off NSAIDs and instead use paracetamol for pain relief.

The study was carried out on 4,705 cases of miscarriage, of which 352 (7.5%) were administered a non-aspirin NSAID. The women who were part of the study were between the ages of 15 to 45. They were compared with 47,050 women of the same age, who did not suffer miscarriage, of whom 1,213 (2.6%) had used an NSAID.

The drug which was found to be the most deleterious, with the highest risk of miscarriage, was Diclofenac when used on its own, and the drug with the lowest risk was rofecoxib. Interestingly the latter was taken out of use in 2004 because of safety concerns.

According to Dr Anick Berard, of the University of Montreal and one of the study’s co-authors, the use of non-aspirin NSAIDs during early pregnancy is associated with statistically significant risk (2.4-fold increase) of having a spontaneous abortion. He said, "We consistently saw that the risk of having a spontaneous abortion was associated with gestational use of Diclofenac, naproxen, celecoxib, ibuprofen and rofecoxib alone or in combination, suggesting a class effect."

The researchers conclude, "Women who were exposed to any type and dosage of non-aspirin NSAID during early pregnancy were more likely to have a spontaneous abortion. Given that the use of non-aspirin NSAIDs during early pregnancy has been shown to increase the risk of major congenital malformations and that our results suggest a class effect on the risk of clinically detected spontaneous abortion, non-aspirin NSAIDs should be used with caution during pregnancy." Earlier studies conducted on similar lines have produced mixed results.

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In order to ensure the safety of the mother and the unborn child the Royal College of Midwives (RCM) and Royal Pharmaceutical Society (RPS) advise that paracetamol would be appropriate to control pain during pregnancy.

According to Janey Fyle, the RCM’s professional policy adviser, the most important advice to pregnant women is to report any pain to the midwife and avoid buying over the counter medication, as it may be contraindicated in pregnancy.

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Jane Bass, women’s health spokeswoman for RPS said, "This study reinforces current advice that women should avoid ibuprofen and other non-steroidal medicines in pregnancy. For most women, paracetamol is the safest painkiller to take at any stage of pregnancy. In certain circumstances, it may be appropriate for women to take medicines like these in the first six months of pregnancy, but only under close medical supervision."

Reference:
Guardian.co.uk

Source-Medindia