Study suggests link between NSAIDs, aspirin, miscarriage

Some specialists say pregnant patients should avoid these painkillers, though many acknowledge shortcomings in the research and call for more data.

By Victoria Stagg Elliott, AMNews staff. Oct. 6, 2003.

It's an age-old saying: Take two aspirins and call me in the morning. But new findings suggest caution in offering this advice to patients who are pregnant.

A study in the Aug. 16 British Medical Journal reopened the complicated question of what medications a woman can take safely during pregnancy and how to balance the health of the woman with that of the fetus.

The study found that taking aspirin or nonsteroidal anti-inflammatory drugs around the time of conception or for longer than a week during pregnancy increased the chance of miscarriage by 80%. No such link was found for acetaminophen. That drug is already the preferred painkiller for pregnant women, and study authors said these data suggested it should also be the drug of choice of women trying to get pregnant.

"Women who are planning on pregnancy or women who are sexually active, but not necessarily planning on pregnancy, and are casual users of painkillers, should switch to acetaminophen or just not use painkillers," said De-Kun Li, MD, PhD, MPH, the study's lead author and reproductive epidemiologist in the division of research at Kaiser Permanente in Oakland, Calif. "For the women who are chronic users, they should talk to their doctors and balance the benefit and the risks."

The Food and Drug Administration already states that NSAIDs should be avoided in the third trimester and that aspirin is only recommended for specific indications throughout pregnancy. Experts, however, said the study was interesting but far too preliminary. Few previous studies of note have suggested such a link.