Non-steroidal anti-inflammatory drugs are not fully safe for fetus: comments on the article Treating common ear problems in pregnancy: what is safe? by Vlastarakos et al.

摘要

Sir,I read with great interest an article by Vlastarakos et al. entitled Treating common ear problems in pregnancy: what is safe? The paper was written by clinicians based on information collected from various databases. However, certain interpretations and conclusions regarding non-steroidal anti-inflammatory drugs (NSAIDs) should be clarified from the teratological point of view.It is true that specific NSAIDs, presently known as nonselective cyclooxygenase (COX) inhibitors, have not proven to be human teratogens with the exception of high doses of aspirin [2-5]. However, in a recently published paper by Ofori et al. -conducted on a large in - 36,387) representative population-a greater risk for all the structural congenital anomalies (OR1 = 2.21; CI2 = 1.72-2.85), especially cardiac septal defects (OR = 3.34; CI = 1.87-5.98), was revealed due to the use of NSAIDs. This article is the only fully available document that presents human prenatal toxicity of selective COX-2 inhibitors (COXIBs).