Non-steroidal anti-inflammatory drugs (NSAIDS) in pregnancy

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are a highly popular, widely used group of drugs to alleviate pain, reduce fever and other inflammatory conditions. In a developing country like India, analgesics are rampantly available as 'over the counter' (OTC) medication. NSAIDs when prescribed for long term for persistent pain or in chronic diseases especially when used in pregnant women, these analgesics may cross the placenta and produce deleterious effects on both the fetal and maternal health. By large, NSAIDs like aspirin, paracetamol appear to be safe and have not been implicated with major teratogenic effects.Occurrence of adverse effects or birth defect may be related to the NSAID chosen, drug dose, frequency and duration and period of drug administration (trimester).NSAIDs act by inhibiting the prostaglandin synthesis, action and also affect physiological changes that occur during pregnancy. Drugs vary in their effect on different fetal developmental stages like miscarriage, fetal malformations, premature closure of ductusarteriosus, acute renal failure, skeletal deformity, intestinal perforation, etc. NSAIDs are advisable during the gestation period only if the maternal benefits outweigh the fetal risks. The consultants and treating doctors should create awareness and counsel their patients regarding the potential deleterious effects to both the mother and fetus while using NSAIDs in expecting mothers.