Publisher： John Wiley & Sons Inc
E-ISSN： 1365-2125|80|4|750-754
ISSN： 0306-5251
Source： BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (ELECTRONIC), Vol.80, Iss.4, 2015-10, pp. : 750-754
Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.
Abstract
AimThe aim of the study was to characterize the extent of indication bias resulting from the excessive use of NSAIDs on the days preceding a spontaneous abortion to relieve pain.MethodsWe used data from a retrospective cohort study assessing the risk for spontaneous abortions following exposure to NSAIDs. Three definitions of exposure for cases of spontaneous abortions were compared, from the first day of pregnancy until the day of spontaneous abortion and until 3 and 2 days before a spontaneous abortion. Statistical analysis was performed using multivariate time programmed Cox regression.ResultsA sharp increase was observed in the dispensation of indomethacin, diclofenac and naproxen, and a milder increase was found in the use of ibuprofen during the week before a spontaneous abortion. Non‐ selective COX inhibitors in general and specifically diclofenac and indomethacin were found to be associated with spontaneous abortions when the exposure period was defined until the day of spontaneous abortion (hazard ratio (HR) 1.15, 95% confidence interval (CI) 1.04, 1.28; HR 1.31, 95% CI 1.08, 1.59 and HR 3.33, 95% CI 2.09, 5.29, respectively). The effect disappears by excluding exposures occurring on the day before the spontaneous abortion for non‐selective COX inhibitors and on the last week before the spontaneous abortion for indomethacin. In general, decreasing HRs were found with the exclusion of exposures occurring on the days immediately before the spontaneous abortion.ConclusionsThe increased use of NSAIDs during the last few days that preceded a spontaneous abortion to relieve pain associated with the miscarriage could bias studies assessing the association between exposure to NSAIDs and spontaneous abortions.
Related content
NSAIDs and spontaneous abortions – true effect or an indication bias?
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (ELECTRONIC), Vol. 306-5251, Iss. 4, 2015-10 ,pp. :
Access to resources
Recommend
Indication bias or protopathic bias?
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (ELECTRONIC), Vol. 306-5251, Iss. 4, 2015-10 ,pp. :
Indication bias or protopathic bias?
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (ELECTRONIC), Vol. 80, Iss. 4, 2015-10 ,pp. :
Jumping translocations in spontaneous abortions
Cytogenetic and Genome Research, Vol. 88, Iss. 1-2, 2000-03 ,pp. :
Reply to ‘Indication bias or protopathic bias?’
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (ELECTRONIC), Vol. 306-5251, Iss. 4, 2015-10 ,pp. :