Anti-inflammatory therapy during pregnancy and lactation.

Acetylsalicylic acid (ASA), other nonsteroidal antiinflammatory drugs (NSAID) and corticosteroids are not known to be teratogenic in humans. Congenital defects have been reported with chloroquine but not in association with gold or D-penicillamine therapy. Likewise, several immunosuppressive agents have been incriminated but azathioprine may be safe to use during pregnancy. Acetylsalicylic acid is considered to be the antiinflammatory drug of choice in pregnancy because of greater experience than with other nonsteroidal antiinflammatory drugs. However adverse effects of acetylsalicylic acid in pregnancy includes prolonged gestation and labour and increased blood loss during delivery. Other nonsteroidal antiinflammatory drugs have been less well studied. Despite the relatively low risks with current antiinflammatory drugs, unnecessary exposure should be avoided in the first trimester and all such medication reduced to a minimum throughout pregnancy.