NSAIDs Consumption Can Increase Risk of Miscarriage

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of drugs that include naproxen, ibuprofen, diclofenac, and celecoxib, and are one of the most common medications used during pregnancy. But recent research of nearly 5,000 women ages 15 to 45 show an increased risk of miscarriage if consumed during early pregnancy.

In a study published in the Canadian Medical Association Journal, researchers from the University of Montreal found the risk of miscarriage is 2.4 times greater for women who took any type and dosage of nonaspirin NSAIDs.

Dr. Joseph I. Fernandez, division director of obstetrics and gynecology at Scott and White Healthcare in Round Rock, Texas said that physicians already shy away from using NSAIDs in later stages of pregnancy because they can interfere with healthy development of fetal circulation.

And now, Dr. Anick Bérard, senior author of the paper, and Bérard's colleagues are studying a different time of pregnancy: the first 20 weeks.

Dr. Bérard is from the University of Montreal and is the Director of the Research Unit on Medications and Pregnancy at CHU Ste-Justine.

The study incorporated data on almost 5,000 women in Quebec who had miscarried and compared these women with 50,000 women who had not miscarried.

The study was not a randomized, controlled trial, which is considered the most sound research method, but Bérard thinks the results are due to the medication and not some other, unrelated factor.

"The use of nonaspirin NSAIDs during early pregnancy is associated with statistically significant risk (2.4-fold increase) of having a spontaneous abortion," Bérard wrote. "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 team of researchers also looked at affects of individual drugs and combinations of drugs. They found the highest risk of miscarriage was associated with diclofenac, alone, and the lowest risk for miscarriage was in users of rofecoxib, alone.

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• Miscarriage