Ibuprofen is a medication that is commonly used for pain relief and inflammation. However, there are some risks associated with its use during pregnancy. Studies have shown that the use of NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen around 30 weeks of gestation or later can lead to the premature closure of the fetal ductus arteriosus, which is a blood vessel in the heart. Maternal use of NSAIDs around 20 weeks of gestation or later has also been associated with fetal renal dysfunction, leading to a condition called oligohydramnios, which is a low level of amniotic fluid. In some cases, this can also result in neonatal renal impairment. These adverse effects may occur after a few days to weeks of treatment, but in some cases, they can manifest as early as 48 hours after initiating NSAID use. However, it should be noted that the decrease in amniotic fluid is often temporary and reversible when the drug is stopped, although there have been cases where renal dysfunction persisted and required invasive procedures for treatment.
It is important to consider the limitations of the available studies and reports, as there is a lack of control groups, limited information on dose, duration, and timing of drug exposure, as well as concomitant use of other medications. Therefore, it is not possible to establish a reliable estimate of the risk of adverse fetal and neonatal outcomes with maternal NSAID use. Moreover, most of the published safety data on neonatal outcomes only involve preterm infants, so it is uncertain how applicable these risks are to full-term infants exposed to NSAIDs through maternal use.
In addition to the potential risks mentioned above, when ibuprofen or other prostaglandin synthesis inhibitors are used to delay preterm labor, there is an increased risk of other neonatal complications such as necrotizing enterocolitis and intracranial hemorrhage. Furthermore, when ibuprofen is given in late pregnancy to delay parturition, it has been associated with persistent pulmonary hypertension, renal dysfunction, and abnormal prostaglandin E levels in preterm infants.
It is important for pregnant individuals to consult with their healthcare provider before using ibuprofen or any other medication to understand the potential risks and benefits and make an informed decision.*