THE TRUTH ABOUT NSAIDS AND PREGNANCY
Just days ago, the American Journal of Obstetrics & Gynecology published a shocking study by the Kaiser Permanente healthcare system titled Use of Nonsteroidal Antiinflammatory Drugs During Pregnancy and the Risk of Miscarriage. I've shown you some of the previous studies associating NSAIDS with almost any problem you can imagine, including cancer (HERE and HERE). Now, we have yet another study linking this class of drug (in SIMILAR FASHION TO FLU SHOTS) to miscarriages. That's right folks, the idea that NSAIDS are related to miscarriage is not a new concept.
"Nonsteroidal antiinflammatory drugs are among the medications most widely used by pregnant women, and previous studies have reported an increased risk of miscarriage that is associated with nonsteroidal antiinflammatory drug use during pregnancy. Although the findings have not always been consistent, there is a well-established mechanism for the association: nonsteroidal antiinflammatory drugs inhibit the production of prostaglandin, which is essential for successful embryonic implantation. Abnormal implantation increases the risk of miscarriage"
Why are NSAIDS popular and "widely used" among pregnant women? Easy; women been told for decades that this class of drugs is safe for them to take when they are 'with child'. As always, I'm curious to see what sort of schizophrenic advice our government and medical community have been giving on this topic.....
- "Prescription NSAIDs and the risk of miscarriage in the first half of pregnancy: Examples of prescription NSAIDs include ibuprofen, naproxen, diclofenac, and celecoxib. We evaluated research studies published in the medical literature and determined they are too limited to make any recommendations based on these studies at this time." From the FDA's web page on the topic titled, FDA Drug Safety Communication: FDA has Reviewed Possible Risks of Pain Medicine Use During Pregnancy
- "Pain relievers from the class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs) won't increase a pregnant woman's risk of miscarriage, according to a new study." From a 2014 article by that pinnacle of medical truth, WebMD (NSAIDs Won't Raise Miscarriage Risk...)
- "NSAIDs given to pregnant women cross the placenta and may cause embryo-fetal and neonatal adverse effects, depending on the type of agent, the dose and duration of therapy, the period of gestation, and the time elapsed between maternal NSAID administration and delivery. These effects derive from the action mechanisms of NSAIDs (mainly inhibition of prostanoid activity) and from the physiological changes in drug pharmacokinetics occurring during pregnancy. Increased risks of miscarriage and malformations are associated with NSAID use in early pregnancy. Conversely, exposure to NSAIDs after 30 weeks' gestation is associated with an increased risk of premature closure of the fetal ductus arteriosus and oligohydramnios." From a 2012 issue of Current Drug Metabolism (Use of Non-Steroidal Anti-Inflammatory Drugs in Pregnancy: Impact on the Fetus and Newborn)
- "To date, studies have failed to show consistent evidence of increased teratogenic effects in either humans or animals following therapeutic doses during the first trimester." From a 2010 issue of the Canadian Family Physician (Treating Pain During Pregnancy)
- "An analysis of 50 pregnant patients who overdosed on ibuprofen revealed no evidence of fetal abnormalities." From the American Family Physician (Over-the-Counter Medications in Pregnancy)
- "NSAIDs should generally be avoided in pregnancy." From the Family Practice Notebook
- "If a woman takes a NSAID the risk of miscarriage is still very low." An official statement from the Royal College of Obstetricians and Gynecologists
- "Centers for Disease Control and Prevention estimates that less than 10 percent of medications approved by the Food and Drug Administration have enough information to determine their risk for birth defects. NSAIDs are used to treat inflammation, control pain and reduce fever. Drugs like aspirin (Excedrin, Bayer), naproxen (Aleve) and ibuprofen (Advil, Motrin) are common NSAIDs. Do not take NSAIDs unless prescribed specifically by a doctor." From Texas A&M's Vital Record (Are Over-the-Counter Drugs Safe During Pregnancy?)
- "There is not enough information to support the negative effects of NSAIDs during pregnancy." From a 2008 issue of Rheumatologia (Systematic Review: Is the Use of NSAIDs Safe During Pregnancy in Women With Rheumatic Disease?)
- "Cat's foot iron claw, Neurosurgeons scream for more. At paranoia's poison door. Twenty first century schizoid man." King Crimson from 1969's 21st Century Schizoid Man (Epitaph)
Although I could have gone on forever, let's clear up the double-mindedness once and for all (after all, a double-minded man is unstable in all his ways). NSAIDS are bad news if you are pregnant, and furthermore this has been a known fact for quite some time. This study went on to say that, "After we controlled for confounding (maternal age, previous miscarriage, multivitamin use, caffeine drinking, and smoking during pregnancy), nonsteroidal antiinflammatory drug use around conception was associated with an increased risk of miscarriage with a dose-response relationship." How bad was it?
Compared to controls, women who took NSAIDS during pregnancy were (gulp) 60% more likely to have a miscarriage, with almost 1/4 of the women taking anti-inflammation meds miscarrying in the first half of their pregnancy. And while other studies have shown that the miscarriages were related to consuming NSAIDS during the first trimester, this study showed that the problem was most severe when the drugs were taken around the time of conception. Oh; not surprisingly, the more drug you took, the greater your chances of miscarrying. Besides the obvious, why is this such a big deal?
Firstly, because as I showed you above, numerous medical mouthpieces continue to tell the public that these drugs are safe to take during pregnancy. Secondly, many of those who are warning women on some level, are doing it with a wink. In other words, it's almost like people are covering their hind ends with the warning and then going on to tell their female patients not to worry about it because the odds of miscarriage or birth defects are so low.
I completely understand why a woman might want to take a pain / anti-inflammation medication at some point in their pregnancy. My advice is to stay far away from these since every study coming out on virtually every drug shows them to be more dangerous than the study published before it, with NSAIDS being no different. To look at it another way, ask yourself why of so many of the drugs given the stamp of approval by OUR TRUSTY FDA are pulled off the market within a decade or so of approval? Hint; reading a few of our posts filed under EVIDENCE-BASED MEDICINE will give you the answer.
A year ago in May, JAMA pointed this out with a study titled Postmarket Safety Events Among Novel Therapeutics Approved by the US Food and Drug Administration Between 2001 and 2010. Of the 222 medications approved, "There were 123 new postmarket safety events (3 withdrawals, 61 boxed warnings, and 59 safety communications)." Writing about this study for CNN, Jen Christensen wrote (she was quoting here), "The key message with all new drugs and technology is that there is an ongoing learning process that will continue through the lifetime of the drug.... There is nothing to be alarmed about with this." Translation: when it comes to prescription and non-prescription medications, the consumer IS ULTIMATELY THE GUINEA PIG!
A 2016 study from BMC Medicine (Post-Marketing Withdrawal of 462 Medicinal Products Because of Adverse Drug Reactions: A Systematic Review of the World Literature) spelled this out via its title (the number 462 only counts drugs pulled from the market through 2014). My advice to you, whether pregnant or not? It's simple; if you don't really have to, don't take drugs. Drugs mess people up whether pushed or prescribed, in ways that scientists may never figure out.
When it comes to successfully addressing INFLAMMATION, an ANTI-INFLAMMATORY DIET is one of the foundational aspects of THE PROTOCOL I give struggling patients to help them start the process of taking their lives back. Oh; and if you liked this post (especially if you have friends or loved ones who are or may become pregnant), an easy way to reach others is via FACEBOOK.
A quick warning for those women who are avoiding NSAIDS but have been told that Tylenol (acetaminophen) is safe to use during pregnancy; I would suggest you do some more research. First, Google "Tylenol ADHD" and then realize that acetaminophen taken by women during pregnancy is actually associated with autism as well as many other issues (HERE and HERE).