NSAID Pain Medication Miscarriage Risk Not Seen: Study

A new study suggests that women who use Aleve, Advil and other over-the-counter painkillers early in their pregnancy may not face an increased risk of suffering a miscarriage, despite prior research that found the use of such non-steroidal anti-inflammatory drugs (NSAIDs) may significantly increase the risk. 

In the July issue of the American Journal of Obstetrics and Gynecology, researchers evaluated the possible connection between miscarriage and NSAID use early in a pregnancy, finding that non-prescription versions of the drug do not increase the risk of a spontaneous abortion.

Known as the Right from the Start study, exposure data regarding over-the-counter NSAID use from the last menstrual period (LMP) through the sixth week of pregnancy were obtained from intake and first-trimester interviews. Conducted from 2004-2010, results of the study concluded that out of the 2,780 pregnancies observed, only 13 percent experienced a spontaneous abortion, with 43 percent reporting exposure to NSAIDS. According to the report, the results were inconclusive, as analyses covered by early and late losses showed no association between NSAID use and risk for early or late-term losses.

The researchers concluded that use of over-the-counter NSAIDs during the first trimester of pregnancy does not put pregnant women at an increased risk of miscarriage. They also pointed out that they could not directly address previous studies which found to the contrary, due to limited numbers and likely higher dosage levels as well.

In September 2011, a study published in the Canadian Medical Association Journal found that women who took NSAIDs during the first 20 weeks of pregnancy were more than twice as likely to suffer a spontaneous abortion than those who had not. Those researchers suggested that they did not find a dose-response effect, meaning that the size of the dosage did not appear to be a factor.

While that earlier study did not make a causal connection between NSAIDs and miscarriages, those researchers suggested that pregnant women use caution with NSAID medications.

In the United States each year, at least 1.5 million women use nonsteroidal anti-inflammatory drugs (NSAIDs) around the time of conception, implantation, and early embryonic development, making them the most common medication exposure reported in the first trimester, which is a time when many women do not even know they are pregnant.

Other studies have linked the use of popular NSAID painkillers to an increased risk of nine different types of birth defect when used during pregnancy, including cleft palate and cleft lip defects, anencephaly, spina bifida, encephalocele, anophthalmia or microphthalmia, transverse limb deficiency, amniotic bands and isolated pulmonary valve stenosis.