Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4, PL 20-090 Lublin, Poland.
Pharmacol Rep. 2012;64(3):521-7. doi: 10.1016/s1734-1140(12)70847-2.
Over-the-counter cyclooxygenase inhibitors are used to relief fever and various types of acute pain like headache, toothache, earache, sore throat, as well as postoperative and menstrual ones. They are also major ingredients in cold and flu mixtures. Unlike well-known organ toxicological profile, their prenatal toxicity was not fully established. For a long time, acetaminophen was considered as a relatively safe antipyretic and analgesic drug during pregnancy. However, a new data indicate that it may increase the risk of cryptorchidism and asthma during childhood as well as preeclampsia, preterm birth, maternal phlebothrombosis and pulmonary embolism. Contrary to acetaminophen, non-selective cyclooxygenase inhibitors (non-steroidal anti-inflammatory drugs - NSAID; i.e., diclofenac, ibuprofen, naproxen) may induce intrauterine growth retardation, ductus arteriosus constriction with secondary persistent pulmonary hypertension, reduced fetal renal perfusion that led to oligohydramion, prolonged pregnancy as well as increase prevalence of intracranial bleeding in newborns. Furthermore, a higher risk of miscarriage, stillbirth and some congenital malformations (cardiac and diaphragmatic defects, celosomy - gastroschisis and umbilical hernia) was reported for non-selective inhibitors, in particular high doses of acetylsalicylic acid (aspirin).
非处方环氧化酶抑制剂用于缓解发热和各种类型的急性疼痛，如头痛、牙痛、耳痛、咽痛，以及术后和月经痛。它们也是感冒药和流感药的主要成分。与众所周知的器官毒理学特征不同，它们的产前毒性尚未完全确定。长期以来，对乙酰氨基酚被认为是一种相对安全的妊娠期间解热和镇痛药。然而，新的数据表明，它可能会增加儿童时期隐睾症和哮喘的风险，以及子痫前期、早产、产妇静脉血栓形成和肺栓塞的风险。与对乙酰氨基酚相反，非选择性环氧化酶抑制剂（非甾体抗炎药，即双氯芬酸、布洛芬、萘普生）可能会导致宫内生长迟缓、动脉导管收缩伴继发性持续性肺动脉高压、胎儿肾灌注减少导致羊水过少、妊娠延长以及新生儿颅内出血发生率增加。此外，非选择性抑制剂（尤其是高剂量乙酰水杨酸（阿司匹林））报告了流产、死产和一些先天性畸形（心脏和横膈膜缺陷、Celosomy-腹裂和脐疝）的风险更高。
