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The association between the use of non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs), such as Celebrex, Advil, Motrin, Voltaren, Aleve, Vioxx during pregnancy and the risk of spontaneous abortion remains unclear. The current study aimed to quantify the association between having a spontaneous abortion and types and dosages of non-aspirin NSAIDs in a cohort of pregnant women. Using a nested case–control design, data was obtained from the Quebec Pregnancy Registry for 4705 women who had a spontaneous abortion. Matched controls were also selected from the registry and the use of non-aspirin NSAIDs and nonuse were compared. The authors also investigated the association between different types and dosages of non-aspirin NSAIDs and having a spontaneous abortion. Adjusting for potential confounders, the use of non-aspirin NSAIDs during pregnancy was significantly associated with the risk of spontaneous abortion. Specifically, use of diclofenac (ie. Voltaren), naproxen (ie. Aleve), celecoxib (Celebrex), ibuprofen (ie. Advil, Motrin) and rofecoxib (ie. Vioxx) alone, and combinations thereof were all associated with increased risk of spontaneous abortion. No dose–response effect was seen, meaning that a pregnant woman taking just 200 mg Advil per day had no decreased risk of spontaneous abortion compared to a pregnant woman taking 800 mg. The authors concluded that gestational exposure to any type or dosage of non-aspirin NSAIDs may increase the risk of spontaneous abortion. Therefore, these drugs should be used with caution during pregnancy (CMAJ. 2011 Sep 6. PMID: 21896698).
Dr. Angela MacNeil