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Popular Painkillers May Increase Risk of Miscarriage

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Feb. 1, 2001 -- A Danish study suggests that taking popular painkillers, such as ibuprofen, during pregnancy does not increase the risk for birth defects or small or premature babies, but may increase the risk of miscarriage.

The research, which is published in the Feb. 3 issue of the British Medical Journal, raises a red flag about the use of a class of painkilling medications known as nonsteroidal anti-inflammatories, or NSAIDs. They include such medications as Aleve, ibuprofen (Advil and Motrin), even aspirin. Many, like aspirin and the ibuprofens, are available over the counter, while others, like Anaprox, are available only by prescription. The medications included in this study were taken in prescription strengths.

NSAIDs are commonly used for pain relief because of their relative safety, lack of side effects, and ability to combat the inflammation that is often associated with painful conditions, such as arthritis and menstrual cramps. Although they are rarely prescribed in the U.S. during pregnancy, the drugs are a staple of many a medicine chest.

Study author Gunnar Lauge Nielsen, MD, tells WebMD that his research confirms previous reports that taking NSAIDs during pregnancy does not appear to lead to birth defects or having an early delivery.

However, the connection between NSAIDs and miscarriage had never before been studied. It was just such a connection that his research uncovered, although it is too early to tell whether taking NSAIDs during pregnancy actually causes miscarriage or whether other factors, such as the medical conditions suffered by the women taking NSAIDs, produced the link. Nielsen is a consultant specialist in internal medicine and gastroenterology at Odder Hospital in Denmark.

Two U.S. experts, Caitlin Fiss, MD, a faculty member in the department of obstetrics and gynecology at Weill-Cornell Medical School in New York, and Andrew Toledo, MD, an assistant clinical professor of obstetrics and gynecology at Emory University in Atlanta, agree that a clear cause-effect relationship between NSAIDs and miscarriage cannot be deduced from this study. However, both would still caution their patients against taking NSAIDs during pregnancy.

Fiss says that NSAIDs already have plenty of effects on the body that are undesirable during pregnancy, including the inhibition of blood clotting. They also do have some effects on development of the fetus.

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