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.
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
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.
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."