Drugs in Pregnancy

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Drugs in Pregnancy

Pain


Acetaminophen is the most commonly used OTC analgesic in pregnancy, with at least 65.5% of women taking it at some point during pregnancy and 54.2% taking it during the first trimester. The use of single-ingredient acetamino-phen products during pregnancy has not been associated with increased risk of a broad range of birth defects. Due to its antipyretic effects, single-ingredient acetaminophen products have been associated with a decreased risk of some birth defects arising from febrile infection during pregnancy.

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided if possible during pregnancy. A recent study found that although the use of NSAIDs in early pregnancy does not appear to be a major risk factor for birth defects, there were a few moderate associations between NSAIDs and specific birth defects. Another major concern is the increased risk of miscarriage that has been associated with the use of nonaspirin NSAIDs during pregnancy. The use of NSAIDs during pregnancy is also associated with premature closure of the ductus arteriosus, fetal renal toxicity, and inhibition of labor. Although there are limited reproductive studies involving the use of narcotic analgesics in human pregnancies, these drugs have been used in therapeutic doses for many years by pregnant women without a link to an elevated risk of birth defects. The use of opioids should be reserved for pain that is not managed with acetaminophen and, when possible, the lowest effective dose should be used.

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