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Pregnancy: no nonsteroidal
anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs in any form should be avoided throughout pregnancy.

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) should not become generalised and should be prohibited for pregnant women.

At the beginning of 2009, the French Health Products Safety Agency (Afssaps) issued a warning on the major risks of NSAIDs in pregnant women after the 6th month of pregnancy. However, this message is incomplete as it does not mention the risks they pose before the 6th month of pregnancy.

There is a pool of evidence confirming that during the second half of pregnancy, NSAIDs expose the newborn to the risk of pulmonary arterial hypertension with premature closure of the arterial duct and renal failure with oligoamnios.

Other evidence suggests that during the first half of pregnancy, NSAIDs expose women to a greater risk of miscarriage and foetal malformation, especially cardiac. These findings apply to all NSAIDs, whether they are administered systemically or locally. Their use should not become generalised, especially since many patients have recourse to them in particular when self-medicating.

If pain or fever relief is necessary in pregnant women, the best treatment is paracetamol which is harmless for the unborn child and newborns, as long as the dosage is adhered to.

©Prescrire June 2009

Source: "AINS: à éviter durant toute la grossesse" Rev Prescrire 2009; 29 (307): 339.

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