Amersham Osteopathic Clinic

Best not to take NSAIDs during pregnancy?

Taking any dose of any non-aspirin non-steroidal anti-inflammatory drug (NSAID) early in pregnancy may more than double the risk of a spontaneous miscarriage are the conclusions of a study published recently in the Canadian Medical Association Journal (CMAJ)

 Non asprin NSAIDs like ibuprofen and diclofenac have been used by pregnant women for headaches, back or neck pain and following injuries. Ibuprofen is sold over the counter. In this study, Naproxen was the most commonly used NSAID, followed by ibuprofen.
A team of Canadian and French researchers analyzed 4705 cases of spontaneous miscarriage up to the 20th week of gestation. 352 (7.5 percent) of women who had a spontaneous early miscarriage had used NSAIDs, but only 1213 (2.6 percent) of a much larger control group (47, 050 women ) who did not miscarry had experienced any exposure to NSAIDs, according to the CMAJ paper.Diclofenac was associated with the highest risk. Dr. Anick Bérard, from the University of Montreal 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.”

“Given that the use of nonaspirin NSAIDs during early pregnancy has been shown to increase the risk of major congenital malformations1 and that our results suggest a class effect on the risk of clinically detected spontaneous abortion, nonaspirin NSAIDs should be used with caution during pregnancy.”

The Royal College of Midwives and the Royal Pharmaceutical Society are now advising against the use of non-aspirin NSAIDs during pregnancy.

However a recent study published in June 2012 in Obstetrics & Gynecology  says that women who use over the counter nonsteroidal anti-inflammatory drugs during early pregnancy are at no increased risk for spontaneous abortion but do note that previous studies of prescription NSAIDs have found a connection between NSAIDs and spontaneous abortion. Prescription NSAIDS may be at higher doses than over the counter NSAIDS.

 

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As well as being principal at Amersham Osteopathic Clinic, I am also Consultant in Charge at the Osteopathic Centre for Children's London clinic (part of the Foundation for Paediatric Osteopathy) and teach theory and practical techniques on the current Diploma course. I am on the Sutherland Cranial College of Osteopathy Teaching Faculty. I teach … Read more...