NSAIDs Won't Raise Miscarriage Risk: Study
However, NSAIDs should not be taken in third trimester of pregnancy, authors advise
A number of factors are known to increase the risk of miscarriage, including genetic abnormalities, maternal diseases, obesity, smoking and consumption of alcohol. Several previous studies had suggested that the use of NSAIDs might also increase the risk of miscarriage.
To see if this was true, the researchers reviewed the records of more than 65,000 women who had conceived between January 2003 and December 2009. Just over 6,500 of the women miscarried at some point during pregnancy, according to the report.
NSAIDs were used by 4,495 women at some point in their pregnancy. Ibuprofen was the most commonly used NSAID. Indomethacin was used by 132 women, and Cox-2 inhibitors were used by just 71 women, the study found.
Overall, the risk of miscarriage in women taking non-Cox-2 NSAIDs -- which includes indomethacin -- was increased by 10 percent. When the researchers looked at women taking indomethacin alone, they found a 2.8 times higher risk of miscarriage. For those taking Cox-2 inhibitors, the risk rose by 43 percent, the study reported.
"Our results show that the use of these drugs in the first trimester is not associated with miscarriage," said Levy.
Levy added that this same research group did a previous study that found that NSAIDs in pregnancy didn't increase the risk of fetal malformations either.
However, Levy and Daniel cautioned that NSAIDs shouldn't be taken during the third trimester of pregnancy.
Dr. Jill Rabin, an obstetrician and gynecologist and chief of ambulatory care and women's health at Long Island Jewish Medical Center in New Hyde Park, N.Y., said that whether or not NSAIDs increased the risk of miscarriage was unknown because there haven't been many studies, and those that have been done had conflicting results. She said it was good to see this study's large sample size.
"If a woman has a clinically important reason to take an NSAID, it probably does not increase the risk of miscarriage," Rabin said. "But, it's important to remember that in pregnancy less is more. Most physicians say it's OK to take Tylenol for a headache if you have to. But, don't take anything without your provider knowing. Always discuss anything you take with your provider." (Tylenol is a pain reliever but not a NSAID.)