NSAID use and Miscarriage

No Brain, No Headache.
Creative Commons License photo credit: Schjelderup

Miscarriage can be especially frustrating in that, in many cases, it’s not easy to tell what exactly may have been the cause. Sure, we know that some activities like smoking can lead to miscarriage, but for many women there’s no obvious explanation. There are many things that can cause miscarriage, and many factors that can increase risk. One of the most recent thing things that’s thought to cause risk of miscarriage is the use of certain NSAIDs (nonsteroidal anti-inflammatory drugs).

This information, which comes from research done in Quebec, suggests that women who used NSAIDs (apart from aspirin) during the early stages of pregnancy had a higher risk of miscarriage. The study looked at 4,705 women who had experienced miscarriage through the 20th week of pregnancy. They then compared those patients from the general population who did not experience a miscarriage.

What they found was that 7.5 percent of women who miscarried had a prescription filled forn an NSAID apart from aspirin during pregnancy, whereas only 2.6 percent of those in the control group had. This works out to a risk of miscarriage of about two and a half times greater for the women who used NSAIDs.

To be sure, nonaspirin NSAIDs aren’t normally recommended for use during pregnancy. They increase the risk of certain congenital defects, and are to be used with caution.

Specific NSAIDs that were linked with miscarriage in the study include ibuprofen (brand name Advil), diclofenac (brand name Voltaren), celecoix (brand name Celebrex), and rofecoxib (brand name Vioxx). The study eliminated other potential causes of miscarriage as a factor, including things like underlying diseases.

It’s not certain why NSAIDs increase risk of miscarriage, although there are some theories. Prostaglandin production is affected by NSAIDs. Prostaglandin levels typically have significant changes during the early part of pregnancy, and if the NSAIDs interfere with that it’s possible that it could affect pregnancy.

The lesson here, as always, is this: check with your doctor before you take any medication when you’re pregnant. Do your homework, and if a given medication seems to carry risk talk to your doctor about an alternative.

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