Burdan Franciszek, Starosławska Elzbieta, Szumiło Justyna, Dworzańska Anna, Dworzański Wojciech, Kubiatowski Tomasz, Cendrowska-Pinkosz Monika, Urbańczyk-Zawadzka Małgorzata
Department of Human Anatomy, Medical University of Lublin, Poland.
Pol Merkur Lekarski. 2012 Jun;32(192):410-3.
Over-the-counter antipyretics (acetaminophen, aspirin, ibuprofen) and/or analgesics (acetaminophen, aspirin, diclofenac, ibuprofen, naproxen) are relatively safe for adults. However, data on their developmental toxicity is sparse. Moreover, experimental and clinical findings are commonly incompatible. The highest developmental toxicity was found for aspirin. However, unlike full-dose of aspirin, its low doses are compatible during pregnancy. Over-the-counter nonselective cyclooxygenase inhibitors (non-steroidal anti-inflammatory drugs, NSAID) may induce miscarriage, stillbirth, intrauterine growth retardation, preterm constriction of the ductus arteriosus with a secondary persistent pulmonary hypertension, reduced fetal renal perfusion that led to oligohydramion, prolonged pregnancy as well as an increase prevalence of intracranial bleeding in newborns. For acetaminophen and ibuprofen an increased risk of cryptorchidism was also pointed. Prenatal exposure to acetaminophen may also induce bronchial asthma during childhood, preeclampsia, preterm birth, maternal phlebothrombosis and pulmonary embolism. Furthermore, epidemiological data suggest higher risk of cardiac, abdominal wall and orofacial defects of evaluated drugs.
非处方退烧药（对乙酰氨基酚、阿司匹林、布洛芬）和/或镇痛药（对乙酰氨基酚、阿司匹林、双氯芬酸、布洛芬、萘普生）对成年人相对安全。然而，关于它们发育毒性的数据很少。此外，实验和临床结果通常不一致。阿司匹林的发育毒性最高。然而，与全剂量阿司匹林不同，其低剂量在孕期是可以接受的。非处方非选择性环氧化酶抑制剂（非甾体抗炎药，NSAID）可能会导致流产、死产、宫内生长受限、动脉导管早产收缩并继发持续性肺动脉高压、胎儿肾灌注减少导致羊水过少、孕期延长以及新生儿颅内出血患病率增加。对于对乙酰氨基酚和布洛芬，还指出隐睾风险增加。产前接触对乙酰氨基酚还可能在儿童期诱发支气管哮喘、先兆子痫、早产、产妇静脉血栓形成和肺栓塞。此外，流行病学数据表明所评估药物导致心脏、腹壁和口面部缺陷的风险更高。
