September 7, 2011
NSAIDs Linked To Risk Of Miscarriage
A new study reported in the Canadian Medical Association Journal reports that any dosage of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) in early pregnancy may cause a woman to miscarry.
Drugs included in the grouping include, naproxen, ibuprofen, diclofenac, and celecoxib, these are reported as the most common drugs used during pregnancy. According to the study the researchers looked at 4,705 spontaneous abortions up to the 20th week of gestation, 352 (7.5%) took non-aspirin NSAIDs. Of the 47,050 women in the control group who did not miscarry, 1213 (2.6%) were reported as being exposed to NSAIDs.
The women in the study ranged in age from 15 to 45 years old on the first day of gestation. They were insured by the Regie de l´Assurance Maladie du Quebec (RAMQ). In Quebec the only available over the counter non-aspirin NSAID is Ibuprofen. The study reports that most women receive ibuprofen as a prescription so that their prescription coverage helps to defray the cost of the drug.
Exposure to NSAIDs in the study is reported as having filled at least one prescription for any type of the drug during the first 20 weeks of pregnancy or the two weeks prior to the beginning of the pregnancy.
Dr. Anick Berard, from the University of Montreal and the Director of the Research Unit on Medications and Pregnancy at CHU Ste-Justine writes, “The use of non-aspirin NSAIDs during early pregnancy is associated with statistically significant risk (2.4 -fold increase) of having a spontaneous abortion. 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.”
But Reuters notes that the study does not prove that NSAIDs themselves caused some women´s miscarriages.
Dr. Berard told Reuters in an interview, “I cannot say, 100 percent, that this is cause-and-effect. But this could very well be a pharmacological effect.”
The study does not pinpoint the biological cause of the miscarriages, but the researchers speculate that prostaglandins play a putative role. The researchers said, “Data suggest that pregnancy is maintained by a mechanism that suppresses uterine synthesis of prostaglandins throughout gestation, and a defect in this inhibitory mechanism may be associated with early loss of pregnancy.”
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