Department of pharmacy, Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Department of pharmacy, Chongqing Health Center for Women and Children, Chongqing, China.
Department of pharmacy, Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Department of pharmacy, Chongqing Health Center for Women and Children, Chongqing, China.
Reprod Toxicol. 2024 Apr;125:108561. doi: 10.1016/j.reprotox.2024.108561. Epub 2024 Feb 27.
There is a high global prevalence of NSAIDs during pregnancy. However, current evidence is largely conflicting regarding the safety of gestational NSAIDs use both for the pregnancy and offspring health. The aim of this study is to systematically review the relationship between NSAIDs use during pregnancy and the risk of adverse pregnancy outcomes and congenital abnormalities. Cohort studies and case control studies on congenital malformations, miscarriage and preterm birth in infants born to mothers who were exposed to NSAIDs during pregnancy were identified via PubMed, Medline, Embase, the Cochrane Library databases and the Reprotox® database from inception to 26 March 2021, and updated on 6 April 2023. On the whole, compared with the unexposed group, infants exposed to NSAIDs during early pregnancy showed a 28% increased risk of overall congenital anomalies (OR 1.28, 95%CI 1.16-1.40), and 19% for major birth defects (OR 1.19, 95%CI 1.08-1.30). Contrary to previous beliefs, there appeared to be a trend towards a higher risk of miscarriage among women who were exposed to NSAIDs during pregnancy, but the association was not statistically significant (OR 1.20, 95%CI 0.93-1.55). According to our study findings, the use of NSAIDs by pregnant women has been linked to a higher risk of congenital anomalies and a negative impact on preterm birth. Therefore, we advise pregnant women to carefully consider the potential benefits and risks before using NSAIDs during pregnancy.
全球妊娠期非甾体抗炎药（NSAIDs）的使用率较高。然而，目前关于妊娠期使用 NSAIDs 对母婴健康的安全性的证据存在很大争议。本研究旨在系统地回顾妊娠期使用 NSAIDs 与不良妊娠结局和先天畸形风险之间的关系。通过 PubMed、Medline、Embase、Cochrane 图书馆数据库和 Reprotox®数据库，从建库至 2021 年 3 月 26 日，以及 2023 年 4 月 6 日更新，检索了妊娠期暴露于 NSAIDs 的母亲所生婴儿的先天畸形、流产和早产的队列研究和病例对照研究。总体而言，与未暴露组相比，妊娠早期暴露于 NSAIDs 的婴儿发生总体先天畸形的风险增加了 28%（OR 1.28，95%CI 1.16-1.40），重大出生缺陷的风险增加了 19%（OR 1.19，95%CI 1.08-1.30）。与之前的观点相反，妊娠期间暴露于 NSAIDs 的女性流产的风险似乎呈上升趋势，但这种关联无统计学意义（OR 1.20，95%CI 0.93-1.55）。根据我们的研究结果，孕妇使用 NSAIDs 与先天畸形风险增加和早产不良结局相关。因此，我们建议孕妇在怀孕期间使用 NSAIDs 之前仔细考虑潜在的益处和风险。
