NSAIDS and Pregnancy
There has been much speculation that taking NSAIDs during pregnancy increases the risk of spontaneous abortion, especially in the later trimesters. In fact, the FDA states in their Medication Guide for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in 2012 that: "NSAID medicines should not be used by pregnant women late in their pregnancy".
Now, for the FDA to add a warning on any medication means that there was extensive research
performed that supported the fact that NSAIDs were not safe during pregnancy. There was a very recent study executed this year which showed some evidence that counters what the medical community has used as guidelines for the past decades.
Benefits in NSAIDs are fast acting reduction in moderate pain, fever, and inflammation. All the benefits of NSAIDs would obviously be desirable to pregnant women whom suffer from a surplus of complications due to pregnancy. This study examined 65,457 pregnant woman admitted to an Israeli hospital during 2003 and 2009.The studied showed that from the vast amount of subjects, 8.2% of the women who took NSAIDs miscarried, and 10% of women who were not exposed to NSAIDs miscarried. This demonstrates primarily that there is not a significant variance between the percent of women that miscarried taking NSAIDs and not taking NSAIDs. Secondly, the results showed the opposite of what has been the popular belief that miscarriage rates are higher in woman who take NSAIDs. The study also analyzed and incorporated risk factors for miscarriages (such as tobacco use, obesity, IVF, uterine malformations, hyper-coagulable conditions, intrauterine contraceptive device) into their statistical data.
Articles from 10 years ago warned the public not to take pain relievers because of their very rare side effects, but in present time its clear that these over the counter drugs can actually be very beneficial in moderation, and when they are not consumed with alcohol. This could be a similar trend in pregnant woman as evident from this study. While I am not suggesting that pregnant woman should all start taking NSAIDs because of this one study, it is a topic of interest that could be promising research in the future.
Citations:
Guide, Medication, For, and Non-Steroidal Anti-Inflammatory Drugs (Nsaids). "FDA.gov." Medication Guide for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) (n.d.): n. pag. US Food and Drug Administration. US Food and Drug Administration, 2012. Web. 2 Dec. 2014. <http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM106241.pdf>.
"Ibuprofen Won't Harm Your Developing Child." Medical Daily. N.p., 3 Feb. 2014. Web. 03 Dec. 2014. <http://www.medicaldaily.com/ibuprofen-nsaids-during-pregnancy-do-not-increase-risk-miscarriage-previous-research-identifying>.
I really enjoyed this post. I had not really thought about the precautions that pregnant women have to take, including not taking NSAIDs. The research you sited was very interesting and I would like to see something similar be done in the United States. I thought it was good to not the large number of women that were studied and the overall low number of miscarriages. I wonder if the procedures was duplicated, if they would get a similar result every time.
ReplyDeleteVery interesting topic! Like Rebecca, I haven't ever considered that there could be serious risks associated with taking something as simple an NSAID during pregnancy. I would be interested to see a study done, like Rebecca said above, in the US. It was interesting to me that they found no significance between miscarriages and taking NSAIDs during pregnancy. These results make me lean more towards utilizing these extremely beneficial drugs even during pregnancy, but again more studies would need to be done to be certain. It seems to me like it would be much more beneficial to relieve headaches and reduce fevers in pregnant women than to leave them untreated.
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ReplyDeleteIt seems that many women would be eager to reach for an NSAID to alleviate some of the minor issues that occur during their pregnancy, so it was great of you to bring up the issue! The results from the study performed in Israel seem to support the idea that these beneficial drugs are okay for women to take during their pregnancy; however I found research showing that NSAIDs elevate the risk of pulmonary hypertension in newborns. The NSAIDs can cross the placenta easily and they cause blockage of the synthesis of thromboxane, ultimately closing the vessel that supplies blood to the lungs of the fetus. Obviously this conflicting issue would be difficult for a woman going through pregnancy to determine, so more in depth research needs to be taken into account.
ReplyDeletehttp://www.medscape.com/viewarticle/406812