A new study of pregnant women in the Quebec province of Canada has found that women who take NSAIDs for pain during the first three months of pregnancy increase the risk of having babies with birth defects, especially cardiac septal defects, which are often described as “holes in the heart.” NSAIDs, or non-steroidal anti-inflammatory drugs, relieve pain by reducing inflammation and are commonly used to relieve arthritis, menstrual, and back pain. Common NSAIDs are available over-the-counter and by prescription and include:

• Aleve (naproxen)
• Advil, Motrin (ibuprofen)
• Celebrex (celecoxib)
• Cataflam, Voltaren (diclofenac)

Dr. Anick Berard and colleagues at Sainte-Justine Hospital studied over 36,000 pregnant women in Quebec province. Women who took NSAIDs were more than twice as likely to have children born with a congenital defect, and three times as likely to risk heart defects that require surgical intervention by septal closure, such as ventricular and atrial septal defects.

A ventricular septal defect, or VSD, is an opening between the two lower chambers of the heart. An atrial septal defect, or ASD, is an opening between the two upper chambers of the heart. Either defect allows oxygenated blood to be pumped back into the lungs, forcing the heart to work harder by displacing the blood that needs oxygen. An infant born with a VSD or ASD can develop high blood pressure and an enlarged heart as a result. Study researchers hypothesize that the NSAID risk to fetuses in the first trimester might be a result of the vascular disruptions that occur as a result of using NSAIDs. Cells within a developing heart that are influenced by the force of pumping blood may be compromised by the decline of vascular pressure caused by an anti-inflammatory drug.

Source: Judith Groch, “NSAIDs during first trimester linked to congenital defects,” MedPage Today, August 24, 2006.