Effects of ibuprofen, diclofenac, naproxen, and piroxicam on ... - Sigo

Safety <strong>of</strong> individual NSAIDs during pregnancy
Table 6. Adjusted odds ratios (ORs) for pregnancy outcomes associated with ibupr<strong>of</strong>en, dicl<strong>of</strong>enac, <strong>naproxen</strong>, or <strong>piroxicam</strong> exposure during pregnancy
Pregnancy outcome Women who used ibupr<strong>of</strong>en, dicl<strong>of</strong>enac, <strong>naproxen</strong>, or <strong>piroxicam</strong> during pregnancy Women
who did
not use any
NSAIDs
during
pregnancy
Use during pregnancy
(total)
Use during the first
trimester
Use during the second
trimester
Use during the third
trimester
(n = 83 906)
n % OR 95% CI n % OR 95% CI n % OR 95% CI n % OR 95% CI n %
Birthweight < 2500 g 2066 2.5
Ibupr<strong>of</strong>en 178 3.3 1.4 1.1–1.6 97 3.2 1.2 0.9–1.6 88 4.1 1.7 1.3–2.3 27 3.1 1.1 0.7–1.8 ref. ref.
Dicl<strong>of</strong>enac 24 4.9 1.6 0.9–2.9 10 5.2 2.4 1.0–5.6 7 6.5 3.1 1.1– 9.0 8 6.6 1.3 0.5–3.7 ref. ref.
Naproxen 12 3.4 1.5 0.8–3.0 6 3.6 1.4 0.5–3.6 2 2.6 0.8 0.1–4.1 1 1.2 – – ref. ref.
Piroxicam 4 2.7 1.0 0.3–3.5 2 2.4 1.1 0.2–6.4 0 0.0 – – 1 4.5 – – ref. ref.
Gestational age < 37 weeks 3651 4.4
Ibupr<strong>of</strong>en 260 4.9 1.1 1.0–1.3 155 5.1 1.2 1.0–1.4 112 5.3 1.2 0.9–1.4 42 4.8 1.0 0.8–1.4 ref. ref.
Dicl<strong>of</strong>enac 32 6.5 1.3 0.9–1.9 10 5.2 1.1 0.6–2.1 6 5.6 1.2 0.5–2.7 12 9.8 1.7 0.9–3.3 ref. ref.
Naproxen 19 5.4 1.2 0.7–1.9 11 6.5 1.6 0.8–2.7 4 5.3 0.9 0.3–2.5 2 2.4 0.5 0.1–2.0 ref. ref.
Piroxicam 7 4.7 1.1 0.5–2.3 3 3.7 0.8 0.3–2.7 0 0.0 – – 1 4.5 – – ref. ref.
Apgar score < 7 at 5 minutes 1021 1.2
Ibupr<strong>of</strong>en 59 1.1 0.8 0.6–1.1 31 1.0 0.7 0.5–1.1 23 1.1 0.9 0.5–1.4 8 0.9 0.9 0.4–1.7 ref. ref.
Dicl<strong>of</strong>enac 4 0.8 0.4 0.1–1.1 2 1.0 0.4 0.1–1.9 1 0.9 – – 1 0.8 – – ref. ref.
Naproxen 4 1.1 0.7 0.2–2.2 2 1.2 1.0 0.2–4.6 1 1.3 – – 1 1.2 – – ref. ref.
Piroxicam 2 1.3 0.8 0.2–3.8 2 2.4 1.7 0.3–9.3 0 0.0 – – 0 0.0 – – ref. ref.
Neonatal respiratory depression 666 0.8
Ibupr<strong>of</strong>en 45 0.8 0.9 0.7–1.3 21 0.7 0.8 0.5–1.2 19 0.9 0.8 0.5–1.4 2 0.2 0.2 0.1–1.0 ref. ref.
Dicl<strong>of</strong>enac 4 0.8 0.5 0.2–1.6 3 1.6 1.3 0.4–4.7 3 2.8 2.1 0.6–8.0 1 0.8 – – ref. ref.
Naproxen 3 0.8 1.0 0.3–3.3 2 1.2 1.3 0.3–5.7 0 0.0 – – 1 1.2 – – ref. ref.
Piroxicam 0 0.0 – – 0 0.0 – – 0 0.0 – – 0 0.0 – – ref. ref.
Referral to specialist for asthmatic symptoms in
the infant during the first 18 months <strong>of</strong> age*
2009 2.4
Ibupr<strong>of</strong>en 182 3.4 1.3 1.1–1.5 96 3.2 1.2 1.0–1.5 86 4.0 1.5 1.2–1.9 40 4.5 1.5 1.1–2.1 ref. ref.
Dicl<strong>of</strong>enac 19 3.9 1.3 0.8–2.1 8 4.2 1.4 0.7–2.9 6 5.6 1.9 0.8–1.3 5 4.1 1.4 0.6–3.4 ref. ref.
Naproxen 7 2.0 0.7 0.3–1.5 4 2.4 0.8 0.3–2.3 2 2.6 0.9 0.2–3.7 2 2.4 0.8 0.2–3.4 ref. ref.
Piroxicam 3 2.0 0.7 0.2–2.3 1 1.2 – – 0 0.0 – – 0 0.0 – – ref. ref.
*Data self-reported by mother. Only infants referred to a specialist for asthma diagnosis were included.
ª 2013 The Authors BJOG An International Journal <strong>of</strong> Obstetrics <strong>and</strong> Gynaecology ª 2013 RCOG 9