Painkillers a miscarriage risk

Women who use common non-steroidal anti-inflammatory drugs (NSAIDs) early in pregnancy may have an increased risk of miscarriage, a study suggests.

Researchers found that of nearly 52,000 Quebec women who had been pregnant, those who'd used an NSAID after conceiving were more than twice as likely to suffer a miscarriage.

The researchers looked at NSAIDs other than aspirin. They found that of 4,705 women who'd had a miscarriage, 7.5% had filled a prescription for an NSAID at some point during pregnancy. That compared with less than 3% of the 47,000 women who had not suffered a miscarriage.

Overall, NSAID use was tied to a 2.4-times higher risk of miscarriage.

Prescriptions linked to miscarriage

In Quebec, ibuprofen is the only non-aspirin NSAID available over the counter. And people there commonly get a prescription for it anyway, to have its cost paid by health insurance.

So the findings suggest that both prescription and over-the-counter NSAIDs may be linked to miscarriage, according to senior researcher Anick Berard, of the University of Montreal's CHU Sainte-Justine Research Centre.

The study, reported in the Canadian Medical Association Journal, does not prove that NSAIDs themselves caused some women's miscarriages.

"I cannot say 100%, that this is cause-and-effect," Berard said in an interview. "But this could very well be a pharmacological effect."

NSAIDs long linked to miscarriage

Some past research, though not all, has also linked NSAIDs to a higher miscarriage risk.

And Berard said the link seen in this study held up even after the researchers accounted for a number of other factors that might explain it – including underlying medical conditions like rheumatoid arthritis (RA) and lupus, and the use of other medications.

The idea is also plausible from the standpoint of biology, according to Berard.

Levels of prostaglandins decline in the uterus during early pregnancy and NSAIDs are known to affect prostaglandin production. The theory is that NSAIDs might affect miscarriage risk by interfering with the normal prostaglandin changes that occur early in pregnancy.

(Reuters Health, September 2011) 

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