Table 6.
Adjusted Odds Ratios (OR) for pregnancy outcomes associated with ibuprofen, diclofenac, naproxen, or piroxicam exposure during pregnancy.
| Pregnancy outcome | Women who used ibuprofen, diclofenac, naproxen, or piroxicam during pregnancy. | Women who did not use any NSAIDs during pregnancy. (n = 83,906) | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Use during pregnancy (total) | Use during the first trimester | Use during the second trimester | Use during the third trimester | |||||||||||||||
| No. | % of n | OR | 95%CI | No. | % of n | OR | 95%CI | No. | % of n | OR | 95%CI | No. | % of n | OR | 95%CI | No. | % of n | |
| Birth weight < 2500g | 2066 | 2.5% | ||||||||||||||||
| Ibuprofen | 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. |
| Diclofenac | 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% | ||||||||||||||||
| Ibuprofen | 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. |
| Diclofenac | 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 min | 1021 | 1.2% | ||||||||||||||||
| Ibuprofen | 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. |
| Diclofenac | 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% | ||||||||||||||||
| Ibuprofen | 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. |
| Diclofenac | 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 of age* | 2009 | 2.4% | ||||||||||||||||
| Ibuprofen | 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. |
| Diclofenac | 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.