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Maternal non-steroidal anti-inflammatory drug exposure during pregnancy and risk of miscarriage: a systematic review and meta-analysis

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Abstract

Background

Numerous studies have suggested that non-steroidal anti-inflammatory drugs (NSAIDs) might be associated with increased risk of miscarriage. However, these results are conflicting and inconclusive.

Methods

We performed this systematic review and meta-analysis to assess the relationship between NSAIDs exposure and risk of miscarriage. A systematic literature search was conducted to identify relevant studies published from the time of database inception until June 2021.

Results

A total of ten studies involving 207,341 pregnant women were subjected to meta-analysis. There was no statistically significantly increased risk of miscarriage with the use of NSAIDs during pregnancy (OR = 1.37, 95% CI 0.99–1.88, p = 0.057). However, our findings showed that women exposed to NSAIDs around the time of conception were at increased risk of miscarriage (OR 2.32, 95% CI 1.16–4.66, p = 0.018). Furthermore, no significant association between NSAID use and miscarriage was evident during the first trimester of pregnancy (OR = 1, 95% CI = 0.83–1.2, p = 0.996), possibly attributable to the small sample size.

Conclusion

Our findings indicate that NSAID exposure around the time of conception might be a risk factor for miscarriage. Further studies are needed to evaluate whether the risk varies by the type, dosage, or timing of NSAID exposure.

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Acknowledgements

X.H.Y. and Y.D.S. conceived the study and revised the manuscript critically for important intellectual content. D.N.B. and H.Y.J. made substantial contributions to its design, acquisition, analysis, and interpretation of data.

Funding

The authors report no funds received for this study.

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Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, Taizhou First People’s Hospital, Taizhou, 318020, Zhejiang, China

    Xian-hua Ying

  2. Department of Clinical Laboratory, Sanmen Peopleʼs Hospital, Taizhou, Zhejiang, China

    Dan-ni Bao

  3. Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, School of Medicine, the First Affiliated Hospital, Zhejiang University, Hangzhou, 310003, Zhejiang, China

    Hai-yin Jiang

  4. Department of Chinese Internal Medicine, Taizhou First People’s Hospital, Taizhou, 318020, Zhejiang, China

    Yu-dan Shi

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Contributions

X.H.Y. and D.N.B. searched the library and wrote the manuscript text. D.N.B. and H.Y.J. extracted data and reviewed all articles. X.H.Y. and Y.D.S. evaluated the bias. Y.D.S. designed the manuscript. All authors reviewed the manuscript.

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Correspondence to Yu-dan Shi.

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Ying, Xh., Bao, Dn., Jiang, Hy. et al. Maternal non-steroidal anti-inflammatory drug exposure during pregnancy and risk of miscarriage: a systematic review and meta-analysis. Eur J Clin Pharmacol 78, 171–180 (2022). https://doi.org/10.1007/s00228-021-03222-w

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