NSAIDs appear safe in pregnancy

Previous research has suggested maternal use of NSAIDs may lead to PPHN but this has been based on case reports or very small studies e.g. 26 infants.

The current case-control study involved 377 women whose infants had PPHN and 836 matched controls drawn from four North American cities over a five-year period.

The data gave no clear picture of the effect of aspirin – due to wide confidence intervals – although the figures suggested that risk may increase with increasing aspirin exposure.

No effect was seen for paracetamol.

The current TGA advice from the Drugs in Pregnancy database is that aspirin (Category C) “should be avoided in the last trimester” as it may cause premature closure of the fetal ductus arteriosis, and delay labour and birth.

The advice for ibuprofen (Category C) is that “continuous treatment with NSAIDs during the last trimester of pregnancy should only be given on sound