Ibuprofen in pregnancy

The ibuprofen

Ibuprofen is a pain reliever that can be purchased at a pharmacy or can sometimes be prescribed by a doctor. It belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). This leaflet summarizes the effects of ibuprofen and other NSAIDs on a baby in the womb.

The use of ibuprofen during pregnancy is not advised unless prescribed by a doctor, especially if you are 30 weeks pregnant or more.

Acetaminophen is generally recommended to control pain or fever during pregnancy. If paracetamol does not control the pain, it is important to ask your doctor for advice before taking ibuprofen or any other NSAID. Ibuprofen may be prescribed during pregnancy for some women with certain diseases; women who need to take ibuprofen after 30 weeks of pregnancy will be monitored by a fetal medicine specialist.

What if I have already taken ibuprofen during pregnancy?

Taking ibuprofen before week 30 of pregnancy is unlikely to harm a baby in the womb. However, if you have taken or are taking any medicines, it is always a good idea to tell your doctor that you are pregnant so that we can decide together if you still need any medicines.

If you have taken ibuprofen after week 30 of pregnancy, it is important that you tell your doctor or midwife as soon as possible.

Can taking ibuprofen while pregnant cause miscarriage?

It’s not clear whether taking ibuprofen in early pregnancy increases the chance of miscarriage. Some studies have shown that women who take NSAIDs during pregnancy are more likely to have a miscarriage than women who have not. However, two of three studies looking at ibuprofen separately from other NSAIDs showed no link to miscarriage.

Can taking ibuprofen while pregnant cause my baby to be born with birth defects?

A baby’s body and most of its internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that certain medications are known to cause birth defects.

Numerous studies have investigated the possible links between taking ibuprofen in the first trimester and birth defects. Current information does not raise the alarm that birth defects are caused by ibuprofen use in pregnancy, although ongoing research is needed.

What problems can taking ibuprofen after 30 weeks of pregnancy cause for my baby?

Before birth, a blood vessel in the baby called the ductus arteriosus must remain open to supply the baby in the womb with the mother’s nutrients and oxygen. The ductus arteriosus closes after birth. ;Premature closure of the ductus arteriosus; is the medical term used to describe this blood vessel that closes prematurely.

Taking ibuprofen or another NSAID after 30 weeks of pregnancy can cause the ductus arteriosus to close while the baby is in the womb. It is important to contact your doctor or midwife immediately if you have taken an NSAID after 30 weeks of pregnancy, especially if you have taken more or more than the recommended dose.

**Persistent Pulmonary Hypertension of the Newborn (PPHN)
**PPHN occurs when a newborn’s lungs don’t adapt to breathing outside the womb. It is thought to be related, in some cases, to premature closure of the ductus arteriosus (see above). PPHN is generally rare but can be serious.

Although two small studies showed a link between PPHN and NSAID use during pregnancy, another larger study did not show a link. More research is needed to evaluate the possibility of PPHN following in utero exposure to NSAIDs and especially ibuprofen.

Oligohydramnios (reduction of fluid around the baby) Using
ibuprofen or other NSAIDs after 30 weeks of pregnancy can result in oligohydramnios (where there is too little amniotic fluid in the sac around the baby).

Ibuprofen should only be taken after the 30th week of pregnancy under medical supervision. If you took ibuprofen after 30 weeks of pregnancy, your obstetrician may want to check your baby (and amniotic fluid levels) using ultrasound.

Can taking ibuprofen while pregnant cause stillbirth?

A single study of about 1,000 pregnant women who took ibuprofen suggested that they had no higher likelihood of stillbirth than women who did not take ibuprofen. While reassuring, this finding should ideally be confirmed with further research. Two studies of women taking NSAIDs during pregnancy also did not show a link with stillbirth.

Can taking ibuprofen while pregnant cause a preterm birth or is my baby small at birth (low birth weight)?

There is no evidence that the use of any NSAID in pregnancy causes premature delivery or low birth weight of the newborn.

Can taking ibuprofen while pregnant cause learning or behavioral problems in the baby?

A baby’s brain continues to develop until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on the baby’s learning or behaviour.

One small study found no differences in learning and behavior in three-year-olds who had been exposed to ibuprofen while in the womb compared to unexposed children. More research is ideally needed to confirm these findings and to investigate the learning and behavior of older children who have been exposed to ibuprofen in utero.

Can taking ibuprofen while pregnant cause other health problems for the baby?

_**One study suggested that babies whose mothers took ibuprofen during the second and third trimesters of pregnancy were more likely to develop asthma by 18 months of age, while a further study did not found no link with asthma. It is possible that women who need to take ibuprofen are more likely to have asthma. Asthma can run in families, which may explain why a study has found a link.

Will my baby need extra monitoring during pregnancy?

Most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects as part of their routine prenatal care. Taking ibuprofen before 30 weeks of pregnancy does not normally require additional monitoring of the baby.

If you took ibuprofen after 30 weeks of pregnancy, extra scans are likely needed to monitor your baby’s well-being. Discuss this with your midwife/midwife.

Are there any risks to my baby if the father has taken ibuprofen?

We wouldn’t expect any increased risk to your baby if the father takes ibuprofen before or around the time the baby was conceived.

Who can I talk to if I have questions?

If you have any questions about any of the information in this leaflet, please talk to your doctor.

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care practitioner. It is very helpful to record all medications taken during pregnancy in portable maternity records.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.

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