From the Guidelines
Ibuprofen should be avoided during pregnancy, especially in the third trimester, due to potential risks to the fetus, and acetaminophen is generally recommended as a safer alternative for pain relief. The use of ibuprofen during pregnancy has been associated with several potential risks, including premature closure of the ductus arteriosus, reduced amniotic fluid levels, and increased risk of bleeding during delivery 1. According to a recent study published in 2021, NSAIDs, including ibuprofen, can be used only during the second trimester, and paracetamol is recommended as the first-line medication for acute treatment of migraine in pregnancy 1.
Some key points to consider when using ibuprofen during pregnancy include:
- Ibuprofen can affect the baby's cardiovascular system and increase the risk of premature closure of the ductus arteriosus 1
- NSAIDs can reduce amniotic fluid levels and affect kidney development 1
- Ibuprofen can increase the risk of bleeding during delivery 1
- In the first trimester, there may be a small increased risk of miscarriage and possibly birth defects 1
It is essential to consult with a healthcare provider before taking any medication during pregnancy, as they can recommend the safest option based on the specific situation, stage of pregnancy, and medical history. The American Academy of Pediatrics considers ibuprofen safe in breastfeeding women, but it is crucial to avoid large doses and use it under medical supervision 1.
From the FDA Drug Label
Use of NSAIDs, including ibuprofen tablets, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment Because of these risks, limit dose and duration of ibuprofen tablets use between about 20 and 30 weeks of gestation, and avoid ibuprofen tablets use at about 30 weeks of gestation and later in pregnancy Premature Closure of Fetal Ductus Arteriosus: Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy, because NSAIDs, including ibuprofen tablets, can cause premature closure of the fetal ductus arteriosus Oligohydramnios/Neonatal Renal Impairment If an NSAID is necessary at about 20 weeks gestation or later in pregnancy, limit the use to the lowest effective dose and shortest duration possible.
Ibuprofen is not safe to use during pregnancy, especially at 30 weeks gestation and later, due to the risk of premature closure of the fetal ductus arteriosus and fetal renal dysfunction. If necessary, the dose and duration of ibuprofen should be limited between 20 and 30 weeks of gestation. 2 2
From the Research
Ibuprofen Use During Pregnancy
- Ibuprofen is a Nonsteroidal Anti-Inflammatory Drug (NSAID) commonly used for pain relief and inflammation reduction.
- The safety of ibuprofen use during pregnancy is a concern due to potential risks to the fetus and mother.
Risks Associated with Ibuprofen Use
- Studies have shown that NSAIDs, including ibuprofen, may increase the risk of early pregnancy loss and miscarriage when used in the first trimester 3, 4.
- Use of NSAIDs in the second trimester is considered reasonably safe, but may be associated with fetal risks such as cryptorchism 3.
- In the third trimester, NSAIDs are usually avoided due to significant fetal risks, including renal injury, oligohydramnios, and constriction of the ductus arteriosus 3, 4.
Specific Studies on Ibuprofen
- A study published in 2018 found no significantly increased risk of major birth defects or spontaneous abortions associated with ibuprofen use in the first trimester 5.
- However, another study published in 2021 found that exposure to ibuprofen in the first trimester may interfere with early nephrogenesis and cause abnormalities in developing kidney structures 6.
Recommendations for Ibuprofen Use During Pregnancy
- Ibuprofen should be used with caution and only when the benefits outweigh the potential risks to the fetus and mother 4, 7.
- The lowest effective dose and shortest duration of treatment should be used to minimize potential risks 4.
- Women should consult their healthcare provider before using ibuprofen during pregnancy to discuss the potential risks and benefits.