Editors:Elham Reshid and Hailemariam Shimelis : Click for the PDF version
Severe and persistent pain that is not effectively treated during pregnancy can result in depression, anxiety, and high blood pressure in the mother. Medicines including non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminophen can help treat severe and persistent pain.
However, it is important to carefully weigh the benefits and risks of using prescription and over the counter (OTC) pain medicines during pregnancy.
Hence, the U.S. FDA reviewed published studies regarding possible risks of using these agents in pain management during pregnancy.
The reviewed studies reported the potential risks associated with the following pain medicines :
- Prescription NSAID such as ibuprofen, naproxen, diclofenac, and celecoxib, and the risk of miscarriage in the first half of pregnancy.
- Opioids, which are available only by prescription, including oxycodone, hydrocodone, hydromorphone, morphine, and codeine, and the risk of birth defects of the brain, spine, or spinal cord in babies born to women who took these products during the first trimester of pregnancy.
- Acetaminophen in both OTC and prescription products is associated with the risk of attention deficit hyperactivity disorder (ADHD) in children born to women who took this medicine at any time during pregnancy.
During the review the FDA found all of the studies to have potential limitations in their designs. Moreover, the studies contained conflicting results on the topic of interest that prevented FDA from drawing reliable conclusions.
As a result, FDA’s recommendations on how pain medicines are used during pregnancy remained the same.
Pregnant women should always consult with their health care professional be-fore taking any prescription or OTC medicine.
Women taking pain medicines who are considering becoming pregnant should also consult with their health care professionals to discuss the risks and benefits of pain medicine use.
Health care professionals should also continue to follow the recommendations in the drug labels when prescribing pain medicines to pregnant patients. It is also important to carefully weigh the benefits and risks of using prescription and OTC pain medicines during pregnancy.
In addition, healthcare professionals should talk with each patient about the benefits and risks of analgesic use during pregnancy, which may differ among patients and by treatment indication.