Despite easy accessibility, Drug Information Online reports that ibuprofen may be unsafe to take during pregnancy. Especially in the last three months, there is a risk of birth defects. Ibuprofen is a non-steroidal anti-inflammatory, or NSAID, drug. This class of medicines has been associated with adverse effects, although studies in pregnant women are limited by ethical concerns. Women who are expecting should not take any medication without the advice of a health care professional. In some situations the drug's benefits may outweigh potential risks.
Birth Defects
During pregnancy, fetal circulation is dependent upon the placenta, which delivers oxygenated blood to the baby's body and heart. Blood is then shunted through the ductus arteriosis to the umbilical arteries that lead back to the placenta for oxygenation by the mother's bloodstream. After birth, dependency on the placenta ends. The ductus arteriosis closes and blood flow is increased to the newborn's lungs, where it now receives oxygen. According to an article on the use of over-the-counter medications during pregnancy, published in the June 2003 issue of "American Family Physician," use of the NSAID indomethacin during the last trimester of pregnancy is known to cause the ductus arteriosis to close prematurely, before the baby is born. The result is a drop in amniotic fluid volume, persistent pulmonary hypertension of the newborn, also known as PPHN, or decreased blood flow to the lungs, kidney damage and bleeding around the heart.
In a 2001 study of Michigan newborns published in "Pediatrics," researchers analyzed the first stools of 40 babies who were born with PPHN, and compared them to the levels of ibuprofen, naproxen, indomethacin and aspirin in the stools of 61 normal infants. PPHN was strongly associated with the presence of one or more medication, including ibuprofen, in the baby's stool. The researchers found the incidence of maternal NSAID and aspirin use was high, despite product warning labels, and called for more extensive public education.
Delayed Labor
One of the reasons that indomethacin has been studied in pregnancy is because it has tocolytic effects, or the ability to stop or delay premature labor. NSAIDS drugs such as ibuprofen inhibit the production of prostaglandins, hormones needed to open the cervix and trigger contractions. Taking ibuprofen within eight weeks of expected delivery could cause a prolonged pregnancy, according an article detailing precautions for physicians who prescribe NSAIDS, which was published in the December 2009 issue of "American Family Physician."
Possible Miscarriage
In the February 3, 2001 issue of the "British Medical Journal," European scientists reported a possible link between NSAID use and an increased risk of miscarriage, defined as pregnancy loss before 24 weeks gestation. In this study 1,462 women who were given prescriptions for NSAID drugs during or just prior to pregnancy were compared with 17,259 pregnant women who were not prescribed any medications. Miscarriages were more frequent in the NSAID group. Of significance was the increased odds of NSAID use in the week prior to miscarriage.
References
- "American Family Physician", Over-the-Counter Medications In Pregnancy, Black R, et. al., June 15, 2003, 67(12)
- "Pediatrics", Analysis of Nonsteroidal Antiinflammatory Drugs in Meconium and Its Relation to Persistent Pulmonary Hypertension of the Newborn, Alano MA, et. al., March 2001, 107(3)
- "American Family Physician", NSAID Prescribing Precautions, Risser A, et. al., Dec. 15, 2009, 80(12)
- "British Medical Journal", Risk of Adverse Birth Outcome and Miscarriage in Pregnant Users of Non-Steroidal Anti-Inflammatory Drugs, Nielsen GL, et.al., Feb. 3, 2001, 322(7281)
- Drugs.com: Ibuprofen
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