According to UCLA Health System, it is estimated that up to
half of all fertilized eggs die and are lost spontaneously, usually before the
woman knows she is pregnant. Among those women who know they are pregnant, the
miscarriage rate is about 15-20%. Most miscarriages occur during the first
seven weeks of pregnancy. The rate of miscarriage drops after the baby's heart
beat is detected. Many factors such as hormone irregularities or infections can
increases the risk of miscarriage; however, a new one has been added to the
list: non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs). Examples of
non-aspirin NSAIDs are ibuprofen (i.e., Advil, Midol, and Motrin) and naproxen
(i.e., Anaprox and Advil). On September 6, Canadian researchers published the
results of their study online in the Canadian Medical Association Journal. It
reported that the ingestion of non-aspirin NSAIDs in early pregnancy is linked
to twice the risk for miscarriage. “The association between the use of
...NSAIDs during pregnancy and the risk of spontaneous abortion [miscarriage]
remains unclear because of inconsistent research results and the lack of
evidence for an effect due to specific types or dosages of non-aspirin NSAIDs,”
wrote Hamid Reza Nakhai-Pour, MD, PhD, from the University of Montreal and CHU
Ste-Justine in Quebec, Canada, and colleagues. “We aimed to quantify the
association between having a spontaneous abortion and types and dosages of
non-aspirin NSAIDs in a cohort of pregnant women.”
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A total of 4,705 women who suffered a spontaneous abortion
were identified from the Quebec Pregnancy Registry. (The medical term for
miscarriage is “spontaneous abortion.) For each patient, the investigators
randomly selected 10 control participants from other women in the registry,
matching by index date, defined as the date of the spontaneous abortion, and by
gestational age. Case patients and control participants were compared in use of
non-aspirin NSAIDs, as reflected in filled prescriptions. The investigators
analyzed associations between different types and dosages of non-aspirin NSAIDs
and spontaneous abortion. Of the 4,705 patients
with spontaneous abortion, 352 (7.5%) had NSAID exposure, as did 1,213 (2.6%)
of 47,050 control participants. The use of non-aspirin NSAIDs during pregnancy
was associated with a 2.43 times greater risk for spontaneous abortion. There
was no apparent dose-response effect; thus, even small doses increased the
risk. The authors concluded: “Gestational exposure to any type or dosage of
non-aspirin NSAIDs may increase the risk of spontaneous abortion.”
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