Pregnant women who use a certain class of painkillers face an increased risk of miscarriage, according to a new study out of Montreal.
Anick Berard of the University of Montreal looked at the link between so-called nonsteroidal anti-inflammatory drugs, or NSAIDs: ibuprofen (Advil), naproxen, diclofenac and celecoxib (Celebrex) and pregnancy outcomes in the province of Quebec since 1997. The paper is in the current Canadian Medical Association journal, now online. (You can download the entire study here.)
Using drug and pregnancy databases, she found that: “The use of nonAspirin NSAIDs during early pregnancy is associated with statistically significant risk (2.4-fold increase) of having a spontaneous abortion,” according to the paper.
The standard risk of clinically detected miscarriage is about 15 per cent, Prof. Berard told the CBC. The doubling of risk associated with use of NSAIDs raises the risk to 30 per cent, she said. Using acetaminophen in the first trimester is fine, she added.
She and her colleagues conclude that the drugs should be used with caution.
Researchers admit more work needs to be done to understand the connection between the anti-inflammitories and miscarriage. They also suggest other, over-the-counter painkillers may have played a role.
Still, Gideon Koren, director of the Motherisk program at Toronto's Hospital for Sick Children, which counsels pregnant women about the risks of various medications during pregnancy, was critical of the research.
He said zeroing in on the specific risk of a drug is difficult, citing a recent paper from Sweden which found that when women were interviewed, many who were prescribed medications in pregnancy never took them.
"The problem is that type of study does not prove anything, but they scare the hell out of women and health professionals," Dr. Koren told the CBC.
Pregnant women are generally already cautious about using any medications.
Will you be talking about this study with your doctor?