What About Ibuprofen During Pregnancy?

Anti inflammatory medications during pregnancy not linked to birth defects but are linked to asthma and bleeding

(RxWiki News) Pregnant women must be cautious about the medications they take because of possible effects to the developing baby. Even over-the-counter medications may have long-term effects.

A recent study found that two anti-inflammatory medications were linked to low birthweight in newborns and asthma in children at 18 months old, when their mothers took the medications during pregnancy.

These links only showed up for ibuprofen and diclofenac when taken during certain trimesters. Diclofenac was also linked to vaginal bleeding in mothers.

The good news is that, of the four anti-inflammatories studied, none of them showed a link to heart defects or other birth defects.

"Attend all prenatal appointments."

This study, led by K Nezvalov√°-Henriksen, of the School of Pharmacy at the University of Oslo in Norway, looked at the possible effects of various anti-inflammatories taken during pregnancy.

The researchers focused on four nonsteroidal anti-inflammatory drugs (NSAIDS): ibuprofen, diclofenac, naproxen and piroxicam.

Ibuprofen is the active ingredient in Advil, and naproxen is the active ingredient in Aleve and Naprosyn. Piroxicam is the active ingredient in Feldene. Diclofenac is an active ingredient in the brand name medications Voltaren, Cambia, Cataflam, Zipsor, Flector, Pennsaid and Solaraze.

The researchers studied 90,417 pregnant Norwegian women, collecting information on the women's medication history, their pregnancy complications, their children's birth outcomes and their children's health at 18 months old.

A total of 6,511 women, or 7.2 percent of the total group, used one or more of the four medications during pregnancy.

The researchers did not find any differences for these women, compared to those who didn't take the NSAIDs, in terms of their babies' survival, heart defects or other birth defects.

However, the researchers did find a link between taking ibuprofen during the second trimester and a lower birthweight in those women's children.

The babies of women who took ibuprofen during the second trimester had about a 1.7 times greater risk of being born with a low birthweight, compared to the babies of women who didn't take ibuprofen.

In addition, the children of women who took ibuprofen in the second or third trimesters were about 1.5 times more likely to have asthma when they were 18 months old.

Diclofenac was also linked to low birthweight when it was taken in the second trimester.

The babies of women taking this medication were about three times more likely to have a low birthweight compared to women who didn't take it.

Women who took diclofenac during the third trimester were about 1.8 times more likely to experience vaginal bleeding as well.

These were the only negative effects that the researchers found to be associated with any of the four anti-inflammatories they studied.

The authors noted that the lack of any connection between NSAIDS and birth defects is "reassuring."

Meanwhile, they wrote that the association between diclofenac and ibuprofen with children's asthma and bleeding in the mothers makes sense based on what these medications do in the body.

They noted, however, that the low birthweight seen in the children of mothers who took diclofenac and ibuprofen may actually be related to underlying inflammatory conditions and not the medications the women were taking to address those issues.

The authors also said the risk of low birthweight linked to these two medications was "reassuringly" close to the expected rate for low birthweight in children.

This study was published in the July issue of the journal BJOG: An International Journal of Obstetrics and Gynaecology.

The research was funded by the Norwegian Ministry of Health and the Ministry of Education of Research, the Norwegian Research Council/Functional Genomics and the National Institutes of Health, including the National Institute of Environmental Health Sciences and the National Institute of Neurological Disorders and Stroke.

The authors declared no conflicts of interest.

Review Date: 
July 30, 2013