Can Painkillers Cause Miscarriage?

Almost everyone takes over the counter painkillers at least occasionally. During pregnancy, with so many new discomforts, many situations can arise that may cause you to want to reach for the painkiller of your choice — back pain, ligament-related aches, headaches, and even painful Braxton-Hicks contractions. Are painkillers safe during pregnancy, though? One important study found that NSAIDs, such as the popular ibuprofen, is linked to an increased risk of miscarriage.

Non-Steroidal Anti- Inflammatory Drugs (NSAIDs) Linked to Miscarriage

Non-aspirin NSAIDs like ibuprofen and naproxen are among the most commonly used drugs during pregnancy, with reports suggesting that almost 17 percent of all pregnant women pop these medicines some time or the other during their pregnancy as they try to find relief from common pregnancy-related pains and aches. These NSAIDs may be acquired either through prescription or over the counter.
 

For the present study, the researchers analyzed the data from the Quebec Pregnancy Registry for 4705 women who had a spontaneous abortion, more commonly called a miscarriage. For every woman who had a miscarriage, the researchers selected ten more women of the same gestational age who served as controls, and then compared the use of NSAIDs in between the two groups. The researchers found that among the nearly 52,000 pregnant women, the women who had used NSAIDs during their pregnancy were twice as likely to suffer from a miscarriage. In fact, 7.5% of the 4,705 women who had spontaneous abortion had used NSAIDs sometime during their pregnancy. Of the remaining 47,000 women who did not have a miscarriage, less than 3% had used NSAIDs during the course of their pregnancy.

The researchers concluded that use of NSAIDs during pregnancy increases the likelihood of miscarriage 2.4 times. According to Dr. Anick Berard, a senior researcher in the study, although the study could not directly prove the role of NSAIDs in causing miscarriage, it could very well be a result of some pharmacological effect of these drugs.

 

NSAIDs may Alter the Normal Prostaglandin Changes in Pregnancy, Resulting in Miscarriage

Though the exact reason behind the association of NSAIDs with miscarriage is not known, it has been postulated that they may alter the normal prostaglandin changes in pregnancy, resulting in miscarriage. Levels of prostaglandin in the blood change during the course of pregnancy. NSAIDs are known to interfere with the normal production of prostaglandins. This may result in miscarriage.

The researchers who led the study found that the association of NSAIDs with miscarriage persisted even after other clinical conditions in the pregnant women who participated, like rheumatoid arthritis and lupus, were taken into account. Therefore, NSAIDs definitely play a role in leading to spontaneous abortion, they concluded. This is all the more true when these medicines are consumed in the early part of pregnancy.

Women, who use NSAIDs for short term pain relief like headache or muscle aches, are therefore advised to stay clear of Non-aspirin NSAIDs during pregnancy. They can instead opt for medicines like acetaminophen (paracetamol or Tylenol), which are considered to be safe in pregnancy.

Those women, who use these medicines for chronic conditions like rheumatoid arthritis and lupus, can consult their physicians, about switching to some alternate medicine or stopping these medicines completely, during their pregnancy.

This option is feasible as most of the chronic conditions go into a phase of remission during pregnancy. Similarly, women planning for a baby, are also advised to avoid these medicines, as in 15% cases, they may suffer from a spontaneous abortion even before they know they were pregnant. Till the time, the exact mechanism of action of NSAIDs in pregnancy is studied, it is better to err on the side of caution.