Aspirin and ibuprofen. Never after the sixth month of pregnancy.
The French Medicines Safety Agency warns that no non-steroidal anti-inflammatory drugs should be taken from the sixth month of pregnancy onwards. According to the medical journal "Prescrire", risks of serious effects for the fetus exist from the first trimester.
By: Cécile Thibert. Le Figaro Santé
Used to relieve pain (joint, muscle, dental, gynecological, migraines and headaches, etc.), fever and inflammation, non-steroidal anti-inflammatory drugs (NSAIDs) have several benefits. Except, as the National Agency for the Safety of Medicines (ANMS) reminded this week, for pregnant women who are six months or more along, who should avoid them completely. This warning is motivated by the fact that, in France, numerous pregnant women (between 5 and 8 per year) receive prescriptions for NSAIDs, despite the contraindications disseminated since 2009 by the country's health authorities.
Even a single dose of these molecules exposes the fetus to an increased risk of irreversible and even fatal heart and kidney failure. According to the ANSM (French National Agency for Medicines and Health Products Safety), this risk arises from the beginning of the sixth month of pregnancy (i.e., from the end of the 5th month or the 24th week of amenorrhea). Furthermore, the Agency clarifies that two non-steroidal anti-inflammatory drugs, celecoxib (Arcoxia) and etoricoxib (Celebrex), are contraindicated throughout the entire duration of pregnancy.
According to the medical journal "Prescrire," which issued its first warning in March 2006, NSAIDs are dangerous not only in the second half of pregnancy but also in the first trimester because of an increased risk of false labor reported in several studies. Since March 2007, the journal has recommended that NSAIDs be avoided "out of caution" from the beginning of pregnancy. The Ansm (French National Agency for Medicines and Health Products Safety), for its part, reminds that these medications should only be used as a last resort, when truly indispensable, and at the lowest effective dose possible and for the shortest duration.
High vigilance
How to recognize these medications, often used for self-medication? We find them in different forms: tablets, pills, gels, creams, suppositories, eye drops, etc. Regardless of the method of administration, they present risks. In March 2008, the Medicines Safety Agency reported the case of a pregnant woman, a physiotherapist, who used a gel containing niflumic acid, an NSAID, two to three times a week in massages she performed without protective gloves. An ultrasound at 22 weeks of pregnancy showed a decrease in fetal movements. For this reason, she immediately stopped using the substance, and at the end of the pregnancy, her child was born without major problems.
It is therefore advisable that pregnant women familiarize themselves with this information and keep a list of the brand names of these medications (aspirin, aspro, ibuprofen, ketoprofen, diclofenac, etc.). It is also advisable to avoid medications containing multiple analgesics in order to avoid the risk of exposure to NSAIDs. Until the 5th month of pregnancy, pregnant women are advised to seek advice from their doctors, nurses, or pharmacists before taking an NSAID.
Paracetamol, the most prescribed medication in France, is a harmless alternative for unborn children, provided the correct dosage is followed. It is present in Doliprane, Dafalgan, and Efferalgan.