What Are the Concerns of Using NSAIDs in Pregnancy?

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are used to treat headaches, muscle aches, arthritis, fever and menstrual cramps. Some tests have indicated that taking NSAIDs in pregnancy could lead to birth defects or miscarriages, though some test results have been inconclusive. Although some doctors may prescribe them in the first or second trimester, there is research indicating that some serious fetal complications can arise when NSAIDs are taken during pregnancy. Used in the first or second trimester of pregnancy, NSAIDs have not been proven to increase risk of fetal malformations. These drugs are so common that some women see no harm in continuing to take them throughout the entire pregnancy.

There are many different conclusions based on a number of studies regarding the effects of NSAIDs in pregnancy. Some studies seem to indicate that taking NSAIDs during the first two trimesters of pregnancy can have an effect on the pulmonary system of a developing fetus. This research also indicates a possible link between NSAIDs in pregnancy and premature closure of the ductus arteriosus, a vessel that causes blood to bypass the lungs in a developing fetus. Other studies indicate a connection between taking NSAIDs in pregnancy and miscarriage. Women who are pregnant or planning to become pregnant should consult with a doctor before taking any medication.

While some research seems to indicate a link between cardiac malformations and NSAIDs in the later stages of pregnancy, these findings have not yet been confirmed. Since these drugs inhibit prostaglandin activity, which may affect the ductus arteriosus, exposure to NSAIDs after 30 weeks of pregnancy is discouraged by most doctors and should be avoided. In situations where NSAIDs are required for treatment during the third trimester, fetal circulation should be monitored with a fetal echocardiogram. If there are no other risk factors present, inadvertent exposure to NSAIDs, even in third trimester pregnancies, does not constitute medical grounds for termination of pregnancy. It is, however, important to remember to check with a doctor and to pay attention to warnings on medication labels.

Since NSAIDs are so common and easily attainable, pregnant women may simply ignore the warnings on the label and assume the drugs are safe. NSAIDs are also present in many over-the-counter (OTC) multi-ingredient medications, like those taken for a cold or allergies. Some women may not be aware of this. Those who discourage the use of NSAIDs in pregnancy have suggested that labels should more strongly communicate the possible dangers posed to a developing fetus. Proponents of this view cite the labeling on alcohol and tobacco products that has helped reduce the overall use of these products by pregnant women.