Painkillers pose risk to pregnancy, says survey

USING certain painkillers such as ibuprofen during pregnancy increase the risk of a woman suffering a miscarriage, according to a survey published yesterday.

Researchers in California studied more than 1,000 pregnant women and found the use of non-steroidal anti-inflammatory drugs (NSAIDs) increased the risk of miscarriage by 80%. They found the risk was higher when NSAIDs, the group of drugs which includes products such as ibuprofen, were taken around the time of conception, or were used for longer than a week.

The team from the Kaiser Foundation Research Institute also found a similar increased risk with aspirin, although the researchers noted the association was weaker and estimates uncertain due to the small number of aspirin users studied.

The research, published in the British Medical Journal, found use of paracetamol during pregnancy was not linked to a greater miscarriage risk. Researchers said while confirmation of their findings was under way it might be wise for doctors and women to be aware of the risk and avoid using NSAIDs around conception.

But Dr Melanie Davies, chairwoman of the Royal College of Obstetricians and Gynaecologists’ guideline and audit committee, pointed out the study was small and women should not be unduly concerned. She also noted it had been advised for some time that women who knew they were pregnant should avoid these painkillers, particularly as paracetamol was an effective alternative.

A total of 1,055 women were interviewed for the survey after their pregnancy was confirmed and asked about their drug use since they became pregnant, their reproductive history and other known risk factors for miscarriage. Fifty-three (5%) said they used NSAIDs around conception or during pregnancy.

NSAIDs, aspirin and paracetamol work by suppressing the production of prostaglandins, fatty acids needed for the successful implantation of an embryo in the womb.

NSAIDs and aspirin act on the whole body which means they could lead to abnormal implantation which puts an embryo at risk.

Paracetamol acts only in the central nervous system which could explain why it has no effect on the risk of miscarriage, the authors explained.