Painkillers tied to miscarriage risk

Women who take common painkillers like ibuprofen and naproxen early in pregnancy may have increased risk of miscarriage. Many times women early in pregnancy do not know they are pregnant and may be taking the drugs without realizing there is a risk. Or for some women who regularly take painkillers for regular daily pain, like old knee injuries or persistent joint pain, they may not know the risk for pregnancy loss with these easily attainable drugs exists.

Researchers in Quebec found that among the 52,000 women they studied who had been pregnant, those who'd used a non-steroidal anti-inflammatory drug (NSAID) after becoming pregnant were twic as likely to experience miscarriage. They looked at NSAIDS which included ibuprofen (Advil and Motrin), naproxen (Aleve, Naprosyn) and the arthritis drug celecoxib (Celebrex).

In Canada, ibuprofen is the only NSAID available over the counter. Prescription is required for the others, but they are easily attainable and the cost is covered by health insurance. Therefore both prescription and over the counter NSAIDS are implicated in the research and linked to miscarriage.

Still, the conclusions are not causal. "I cannot say, 100 percent, that thi is cause-and-effect," said Anick Berard of the University of Montreal's CHU Sainte-Justine Research Center. "But this very well could be a pharmacological effect."

They do know that levels of hormone-like substances called prostaglandins decline in the uterus during early pregnancy and NSAIDs are known to affect prostaglandin production. NSAIDs may cause miscarriage by interfering with the normal prostaglandin levels.

For women who are taking painkillers for short term pain and are trying to conceive, it may be better to switch to acetaminophen (Tylenol) which is a safer choice. Talk to your doctor if you need to discuss safer long term pain management options.

Source: CMAJ, Reuters