The FDA Just Changed Its Guidelines On NSAIDs And Pregnancy

Pregnancy can be a real headache, all right — quite literally, since headaches, as well as other bodily aches and pains, are a symptom experienced by many expectant moms. Unfortunately, you can't always cure said headache just by reaching for your trusty bottle of ibuprofen. According to a recent press release from the U.S. Food and Drug Administration, non-steroidal anti-inflammatory drugs (also known as NSAIDs) such as ibuprofen, naproxen, diclofenac, and celecoxib are now no longer considered safe for use by women who are past their 20th week of pregnancy (women 30-plus weeks on were already advised to avoid such medications).

The reason for the warning is because NSAIDs can cause kidney problems in unborn babies, and these kidney problems, in turn, can lead to lower levels of amniotic fluid, since the fluid is primarily being produced by the fetus itself at this point. Low amniotic fluid can lead to all manner of birth complications, and the level could drop after as little as two days of NSAID use. Luckily, the levels usually rise again after drug use is discontinued, but it's best to just avoid this happening in the first place. If a pregnant woman must use NSAIDs for any reason once she's 20 weeks pregnant or more, she should only do so under a doctor's supervision, and only using the lowest effective dose for as short a time as possible.

Although aspirin is technically an NSAID, the FDA does state that its recommendations regarding these types of drugs do not apply to low-dose aspirin (81 mg). They do still advise that any pregnant women making use of it should consult with their physician first.

Healthcare provider Kaiser Permanente says that acetaminophen (Tylenol and its knockoffs) is also safe for use by pregnant women as long as they don't exceed the maximum dose. Women who use painkillers on a regular basis, however, should be aware that a study published in the American Journal of Epidemiology (via Oxford Academic) shows that extended usage of acetaminophen by a pregnant woman has been linked to a higher risk of her baby's developing ADHD or an autism spectrum disorder. By "extended," they mean 28 days or more during the course of a pregnancy, but these results, which come from a study involving more than 100,000 women followed up for between 3 to 11 years, are statistically significant: 30 percent increased risk of ADHD, 20 percent increased risk of ASD (although, as is often the case, this study might have limitations, and the authors recommend interpreting results with caution).

So yes, there's no easy solution to pregnancy pain management, but the baby's safety should always come first. After all, you can never be too careful when it comes to protecting another person's health, particularly at a time when they're 100 percent reliant on you to make good decisions for them.