Pregnancy is a time of increased vulnerability to various infections. However, it is crucial to ensure that any medication taken is safe for the developing child. During colds or fevers, many people reach for medications containing ibuprofen. But is it safe to take ibuprofen during pregnancy?
What is ibuprofen?
Ibuprofen belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). It has anti-inflammatory, pain-relieving, and fever-reducing properties. It is metabolized in the liver and excreted through the urine. The main mechanism of action of ibuprofen is the inhibition of the enzyme cyclooxygenase. This enzyme is responsible for the production of prostaglandins – protein compounds that play a key role in the development of inflammation. One of the functions of prostaglandins is to increase the permeability of blood vessels at sites of inflammation, allowing white blood cells easier access to the affected area. By inhibiting cyclooxygenase, ibuprofen blocks the inflammatory response and thus also typical symptoms such as fever, weakness, and pain. Ibuprofen is contraindicated in individuals who are hypersensitive to NSAIDs or who have an active stomach ulcer.
Ibuprofen in pregnancy – is it allowed?
Animal studies have not shown any harmful effects of ibuprofen on the fetus. However, it is recommended that the drug not be taken during the first trimester, as it may increase the risk of miscarriage during this early phase. Due to a lack of comprehensive studies in humans, ibuprofen should only be used during the second trimester if absolutely necessary. For pain, medications containing paracetamol are considered a much safer choice during pregnancy.
It should also be noted that many over-the-counter cold and flu remedies contain pseudoephedrine – a substance pregnant women should avoid. In general, any medication use during pregnancy should be discussed with a doctor or pharmacist. When experiencing cold symptoms, it is best to first try home remedies for relief.
Ibuprofen in the third trimester
The most critical period for taking ibuprofen during pregnancy is the third trimester. During this phase, taking the medication can lead to serious complications – especially the premature closure of the ductus arteriosus (Botalli) in the fetal heart. Prostaglandins play a crucial role in keeping this vessel open. If their production is inhibited by ibuprofen and insufficient amounts are available, the ductus arteriosus may constrict. This disrupts the function of the fetal cardiovascular system, as the blood can no longer bypass the lungs. A possible consequence is pulmonary hypertension – an increased blood pressure in the unborn child’s lungs.
Interestingly, ibuprofen is deliberately used after birth to close a persistent ductus arteriosus if it does not close naturally – in such cases, the medication can help avoid surgery.
Complications from ibuprofen during pregnancy
In addition to the risks in the third trimester, there are also indications of possible complications in early pregnancy. In the first trimester, ibuprofen may increase the risk of bleeding. Furthermore, NSAIDs can reduce blood flow to the placenta, impair the fetal kidney function, and decrease the amount of amniotic fluid. A prolonged duration of labor is also possible. For these reasons, ibuprofen should only be taken during pregnancy when absolutely necessary and always in consultation with a healthcare provider.