Periconceptional over-the-counter nonsteroidal anti-inflammatory drug exposure and risk for spontaneous abortion.
OBJECTIVE
To estimate the association between over-the-counter nonsteroidal anti-inflammatory drug (NSAID) exposure during the early first trimester and risk for spontaneous abortion (gestation before 20 weeks of gestation) in a prospective cohort.


METHODS
Women were enrolled in the Right from the Start study (2004-2010). Exposure data regarding over-the-counter NSAID use from the last menstrual period (LMP) through the sixth week of pregnancy were obtained from intake and first-trimester interviews. Pregnancy outcomes were self-reported and verified by medical records. Gestational age was determined from the LMP. Stage of development before loss was determined from study ultrasonography. Cox proportional hazards regression models were used to estimate the association between NSAID exposure and pregnancy outcome taking into account candidate confounders.


RESULTS
Among 2,780 pregnancies, 367 women (13%) experienced a spontaneous abortion. NSAID exposure was reported by 1,185 (43%) women. NSAID exposure was not associated with spontaneous abortion risk in unadjusted models (hazard ratio [HR] 1.01, 95% confidence interval [CI] 0.82-1.24) or models adjusted for maternal age (adjusted HR 1.00, 95% CI 0.81-1.23).


CONCLUSIONS
Our findings suggest that use of nonprescription over-the-counter NSAIDs in early pregnancy does not put women at increased risk of spontaneous abortion.
Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Department of Obstetrics and Gynecology, and the Center for Human Genetics Research, Vanderbilt University, Nashville, TN, USA. digna.r.velez.edwards@vanderbilt.edu
Digna R Velez
DR
Edwards
Tiara
T
Aldridge
Donna D
DD
Baird
Michele Jonsson
MJ
Funk
David A
DA
Savitz
Katherine E
KE
Hartmann
D000022:Abortion, Spontaneous / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000009:adverse effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000187:drug effects; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D016216:Ultrasonography, Prenatal
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004366:Nonprescription Drugs