The association between the use of non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy and the risk of spontaneous abortion remains unclear. The current study was conducted to assess 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. Ten controls were randomly selected for each case and were matched by date of the spontaneous abortion and gestational age. Adjusting for potential confounders, the use of non-aspirin NSAIDs during pregnancy was significantly associated with the risk of spontaneous abortion (OR: 2.43; 95% CI: 2.12–2.79). Specifically, use of diclofenac (OR: 3.09; 95% CI: 1.96–4.87), naproxen (OR: 2.64; 95% CI: 2.13–3.28), celecoxib (OR: 2.21; 95% CI: 1.42–3.45), ibuprofen (OR: 2.19; 95% CI: 1.61–2.96), and rofecoxib (OR: 1.83; 95% CI: 1.24–2.70) alone, and combinations thereof (OR: 2.64; 95% CI: 1.59–4.39), were all associated with increased risk of spontaneous abortion. No dose–response effect was seen. The authors concluded that these drugs should be used with caution during pregnancy. CMAJ. 2011 Sep 6. PMID: 21896698.
