This sheet is about having H5N1 flu in a pregnancy or while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is H5N1 flu?

The flu (influenza) is an infection of the respiratory (breathing) tract. The flu is caused by a group of viruses called influenza virus. H5N1 flu is caused by an avian (bird) influenza virus primarily found in wild birds, poultry, and U.S. dairy cows.

How do you get H5N1 flu?

H5N1 can be spread to humans through exposure to infected animals. This includes contact with an infected animal’s saliva, mucous, feces (poop), and milk. People can get H5N1 flu from the virus getting into their eyes, nose, and mouth, or when it is breathed in. At this time, most people are not considered to be at high risk of getting H5N1 flu. People that work with or have close contact with animals or animal products are at a higher risk of being exposed to H1N1 flu. H5N1 flu can be spread from person to person, but this is rare.

What are the symptoms of H5N1 flu?

Common symptoms of H5N1 flu include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue, eye redness, shortness of breath, or trouble breathing. Less common symptoms include diarrhea, nausea, vomiting, or seizures. A severe case of H5N1 flu can be fatal. Women who are pregnant are more likely to experience severe symptoms and death than those who are not pregnant.

People who think they have been exposed to H5N1 infected birds, other animals, or humans should monitor themselves for respiratory symptoms and eye redness for 10 days after their exposure. Anybody who develops symptoms after exposure to H5N1 should seek medical attention immediately. It is important to treat H5N1 flu as early as possible.

How can I protect my pregnancy from H5N1 flu?

To help prevent H5N1 flu infections, the Centers for Disease Control and Prevention (CDC) recommends that people avoid exposure to sick or dead animals, including wild birds, poultry, other domesticated birds, and other domesticated and wild animals (including cows). It is also recommended to avoid exposures to animal feces, bedding, litter, unpasteurized (“raw”) milk, and materials that have been touched or were close to infected animals.

People who come in contact with domesticated and wild animals (such as poultry and livestock workers, veterinary staff, bird flock owners, and emergency responders) should use appropriate protective gear and avoid direct physical contact or close exposure with infected or potentially infected animals or materials. Personal protective equipment (PPE), such as thick disposable gloves, protective clothing, and a mask, should be worn when in contact or near sick birds, livestock, other animals, animal carcasses (dead bodies), feces, litter, raw milk or surfaces and water that may be contaminated. All staff members should wear PPE whether they are pregnant or not. Proper hand washing is also critical. For more information, please visit CDC’s page on reducing risk for people working with or exposed to animals: https://www.cdc.gov/bird-flu/prevention/worker-protection-ppe.html. MotherToBaby also has a general fact sheet on working as a Veterinarian or Veterinarian Technician at https://mothertobaby.org/fact-sheets/vet-vettech/ and a general sheet on workplace safety tips at https://mothertobaby.org/fact-sheets/reproductive-hazards-workplace/.

Poultry, eggs, and beef should be cooked to a safe internal temperature to kill bacteria and viruses. Pasteurized milk and foods made with pasteurized milk are not expected to be contaminated with H5N1 flu. Unpasteurized “raw” milk and unpasteurized milk products (such as soft cheeses, ice creams, and yogurts) can be contaminated with H5N1 virus and other bacteria. Pasteurization kills H5N1 virus.

How can I find out if I am infected with H5N1 flu?

If you think you are infected with H5N1, seek medical attention as soon as possible. A healthcare provider can order H5N1 laboratory testing for you. Over-the-counter rapid flu tests will not be able to tell the difference between seasonal flu and H5N1 flu.

What should I do if I think I have been infected with H5N1 flu?

CDC has recommended that anyone with suspected or confirmed H5N1 flu receive an antiviral treatment for H5N1 as soon as possible. The World Health Organization (WHO) recommends that women who are pregnant and have suspected or confirmed H5N1 flu receive antiviral treatment, regardless of how far along in pregnancy they are. It is important that you seek medical attention if you think you have H5N1 flu. Because of the increased risk of death in women who are pregnant and have H5N1 flu, the benefits of antiviral therapy outweigh any potential risks. There is no vaccine available for H5N1 flu.

MotherToBaby has a general fact sheet on antiviral medications for the flu here: https://mothertobaby.org/fact-sheets/antiviral-medications-treatprevent-influenza-the-flu-pregnancy/.

I have H5N1 flu. Can it make it harder for me to become pregnant?

It is not known if H5N1 flu can make it harder to get pregnant.

Does having/getting H5N1 flu increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if H5N1 flu can increase the chance of miscarriage. Miscarriage has been reported in 2 women who had H5N1 flu. It is important to talk with your health care provider if you are pregnant and have symptoms of the H5N1 flu to receive treatment.

Does having/getting H5N1 flu increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Because getting flu from the H5N1 virus is rare in humans, it is not known if having H5N1 flu increases the chance for birth defects above the background risk. However, other types of influenza viruses have not been shown to cause birth defects.

Fever is a possible symptom of H5N1 flu. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen has been recommended as an option to reduce fever in pregnancy. If you have H5N1 flu and develop a fever, talk with your healthcare provider about the best way to treat your fever. For more information about fever and pregnancy, see the MotherToBaby fact sheet about hyperthermia at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/ and a fact sheet on acetaminophen here: https://mothertobaby.org/fact-sheets/acetaminophen-pregnancy/.

Would having/getting H5N1 flu increase the chance of other pregnancy-related problems?

It is not known if H5N1 flu can cause preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). There have been 2 reports of preterm delivery in women who had H5N1 virus.

Can H5N1 flu be passed to the baby during pregnancy or at the time of delivery?

When a woman is pregnant and passes an infection to the fetus, it is called vertical transmission. Vertical transmission has been reported with H5N1 flu in pregnancy, but is thought to be rare. Vertical transmission can happen at any time in pregnancy, but is more likely to happen when someone gets the infection close to the time of delivery.

Does having/getting H5N1 flu in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if H5N1 flu can increase the chance of behavior or learning issues for the child.

Breastfeeding while I have H5N1 virus:

CDC encourages women to continue to breastfeed or provide breast milk for their babies even if they have the flu. There are antibodies in breast milk that might help prevent a baby from getting sick with the flu. Women with H5N1 flu may feel too sick to breastfeed. CDC recommends that breastfeeding women who have the flu should continue to express milk when possible. A woman with the flu might have a lower breast milk supply than normal. There are no breastfeeding recommendations specific to H5N1 flu.

While sick, it is important to try to protect the baby from getting sick. Wash your hands with soap and water before holding your baby. Avoid coughing or sneezing on your baby. Cover your mouth/nose with a tissue when you cough or sneeze, then throw away the tissue and wash your hands. While you are ill, you may want to consider having someone who is not sick help you care for your baby. CDC has more information on the flu and breastfeeding at https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/flu.html. If you think your baby has symptoms of H5N1 flu, contact your child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man has H5N1 flu, can it make it harder to get a woman pregnant or increase the chance of birth defects?

Illnesses that cause fever, such as H5N1 flu, might cause a temporary reduction in the movement or number of sperm, which could make it harder to get a woman pregnant during that time. Close contact may not be recommended when you have H5N1 flu in order to avoid passing H5N1 flu to your partner. In general, however, exposures that men have are unlikely to increase the risk to a pregnancy. For more information, please see the fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

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This sheet is about exposure to oral prednisone or prednisolone in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What are prednisone and prednisolone?  

Prednisone and prednisolone belong to a group of medications called corticosteroids. In the body, prednisone is broken down into prednisolone. Prednisone and prednisolone have been used to treat many conditions, such as asthma, autoimmune diseases, and skin conditions. They help prevent or suppress inflammation (swelling and irritation) and immune responses. Prednisone and prednisolone are prescribed in a wide range of doses, depending on what condition is being treated. For more information on asthma, see our fact sheet here: https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/.  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I take prednisone or prednisolone. Can it make it harder for me to get pregnant? 

Taking prednisone or prednisolone is not expected to make it harder to get pregnant.   

Does prednisone or prednisolone increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Taking prednisone or prednisolone is not expected to increase the chance of miscarriage. One study found that oral immunosuppressant medications, including prednisolone, might improve pregnancy outcomes in women with unexplained recurrent miscarriage (2 or more pregnancies that end in miscarriage) by lowering the chance of miscarriage. 

Does prednisone or prednisolone increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like prednisone or prednisolone, might increase the chance of birth defects in a pregnancy. 

Taking prednisone or prednisolone is not expected to greatly increase the chance of birth defects. Older studies suggested a very small possible increase in cleft lip and/or cleft palate (an opening in the upper lip or the roof of the mouth), when used in the first trimester. But newer studies and further review of the older studies have not confirmed this finding. If there is an increased risk, it appears to be very small, and most pregnancies would not be affected. 

Does taking prednisone or prednisolone in pregnancy increase the chance of other pregnancy-related problems? 

Taking an oral corticosteroid like prednisone or prednisolone long-term during pregnancy has been associated with an increased chance of preterm delivery (birth before week 37) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). However, it is hard to know whether these outcomes are related to the medications themselves or to the underlying medical conditions being treated. Conditions requiring corticosteroid treatment may also increase the chance of pregnancy complications. Other studies have shown that using prednisone or prednisolone might improve some pregnancy outcomes. The benefits of taking prednisone or prednisolone and treating your condition should be weighed against possible risks to the pregnancy. 

Does taking prednisone or prednisolone in pregnancy affect future behavior or learning for the child?   

A review of 14 studies found no consistent evidence that corticosteroid use during pregnancy increases the chance of learning, behavior, or developmental problems in children. Most outcomes showed no differences between exposed and unexposed children. 

Breastfeeding while taking prednisone or prednisolone: 

Prednisone and prednisolone get into breast milk in small amounts. Prednisone is like the body’s natural hormones that are needed for milk production. High doses can sometimes cause temporary loss of milk supply. There are reports of ~190 infants exposed to prednisone or prednisolone through breast milk with no reported side effects. 

The amount of prednisone or prednisolone in breast milk might be higher in women taking higher doses. Waiting 4 hours after taking it before breastfeeding can also limit the amount of medication the baby gets in the breast milk. However, this is not necessary for everyone. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes prednisone or prednisolone, could it affect his fertility or increase the chance of birth defects? 

Small studies on men who had organ transplants and were being treated with medications that suppress the immune system (including prednisone and prednisolone) did not report lower rates of male fertility (ability to make healthy sperm). Studies have not been done to see if taking prednisone or prednisolone could increase the chance of birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references. 

This sheet is about exposure to clozapine in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is clozapine?

Clozapine is a medication that has been used to treat schizophrenia and schizoaffective disorders. Some brand names are Versacloz®, FazaClo®, and Clozaril®.

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I take clozapine. Can it make it harder for me to get pregnant?

Studies have not been done to see if clozapine can make it harder to get pregnant.

Does taking clozapine increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Information from 3 studies that looked at approximately 225 pregnancies exposed to clozapine does not suggest an increased chance of miscarriage.

Does taking clozapine increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. It is not known if clozapine can increase the chance of birth defects. One reviewer combined studies and reported a birth defect rate of 4.5% out of 264 infants with first trimester exposure to clozapine. This is similar to the background risk of birth defects.

There are case reports of infants with birth defects after exposure to clozapine in the first trimester. No pattern of birth defects was identified to suggest the birth defects noted were related to a single medication. There are also reports of babies without birth defects after prenatal exposure to clozapine.

Does taking clozapine in pregnancy increase the chance of other pregnancy-related problems?

It is not known if clozapine can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). No differences in birth weight or gestational age were reported in 187 children exposed to clozapine or another medication called olanzapine during pregnancy, when compared with an unexposed group.

Some studies have suggested an increased chance for pregnant women to develop gestational diabetes when clozapine is used in pregnancy. Gestational diabetes can lead to babies that are bigger than expected (called large for gestational age). Be sure to talk with your healthcare provider about your chances of gestational diabetes. They can go over any screenings, tests, or treatments they recommend for you. For more information about gestational diabetes, see the MotherToBaby fact sheet here: https://mothertobaby.org/fact-sheets/diabetes-pregnancy/

I need to take clozapine throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

The use of clozapine during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Some babies have also had unexplained seizures. There is one case report of a baby who had had a low white blood cell count. White blood cell count helps to see how a person’s immune system is working. If the immune system is not working well, a person could have a harder time fighting off infection. One case report cannot prove that the low white blood cell count was due to clozapine exposure in pregnancy.

Newborns exposed to clozapine during late pregnancy can be monitored for symptoms such as too much or too little muscle tone (stiff or floppy), sleepiness, agitation, problems with breathing and feeding, or unusual muscle movements (tremors). Not all babies exposed to clozapine will have symptoms. Let your baby’s healthcare providers know you are taking clozapine so that if symptoms occur your baby can get the care that is best for them.

Does taking clozapine in pregnancy affect future behavior or learning for the child?

It is not known if clozapine can increase the chance of behavior or learning issues for the child. One study compared the development of infants exposed to clozapine during pregnancy to that of infants exposed to other antipsychotic medications and found some behavior delays at age 2 months and 6 months of age. However, the difference was not noticed by age 1 year.

Breastfeeding while taking clozapine:

Information about the use of clozapine during breastfeeding is very limited. Drowsiness (being sleepier than usual) was reported in 1 infant exposed to clozapine in breastmilk. Another infant developed agranulocytosis (a life-threatening blood disorder when the body doesn’t make enough white blood cells). There are reports of breastfed infants who did not have side effects. If you are breastfeeding while taking this medication, the infant should be closely watched for drowsiness and have their white blood cell count checked by a healthcare provider.

The product label for clozapine recommends that breastfeeding women not use this medication. However, the benefit of using clozapine and nursing may outweigh the possible risks to your baby. Your healthcare providers can talk with you about using clozapine and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes clozapine, could it affect his fertility or increase the chance of birth defects?

There is a report of a man who was taking clozapine and had trouble with ejaculation, which could make it harder to get a woman pregnant. This issue resolved when the medication was stopped. Studies have not been done in males to see if clozapine could increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here to view references.

This sheet is about exposure to ofatumumab in pregnancy and while breastfeeding. This information is based on research studies. It should not take the place of medical care and advice from your healthcare providers. 

What is ofatumumab?

 

Ofatumumab is a monoclonal anti-CD20 antibody that works by lowering the amount of B cells in a person’s body. B cells are a type of white blood cell that makes antibodies. Ofatumumab has been used to treat adults with relapsing forms of multiple sclerosis (MS). MotherToBaby has a fact sheet on multiple sclerosis here: https://mothertobaby.org/fact-sheets/multiple-sclerosis/. Ofatumumab has also been used to treat chronic lymphocytic leukemia. Some brand names for ofatumumab are Kesimpta® and Arzerra®.   

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I am taking ofatumumab, but I would like to stop taking it before becoming pregnant. How long does the drug stay in my body?

 

People eliminate medication at different rates. In healthy adults, it takes up to 96 days (a little over 3 months), on average, for most of the ofatumumab to be gone from the body. 

The product label for ofatumumab recommends that females who can get pregnant should use an effective method of birth control while taking this medication and to continue to use birth control for 6 months after stopping ofatumumab. 

I take ofatumumab. Can it make it harder for me to get pregnant? 

 

It is not known if ofatumumab can make it harder to get pregnant. 

Does taking ofatumumab increase the chance for miscarriage? 

 

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done in humans to see if ofatumumab can increase the chance for miscarriage. Miscarriage has been reported in people exposed to ofatumumab during pregnancy. 

Does taking ofatumumab increase the chance of birth defects? 

 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like ofatumumab, might increase the chance of birth defects in a pregnancy. 

There is limited published information describing people who were exposed to ofatumumab during pregnancy. No birth defects were reported in over 20 pregnancies exposed to ofatumumab. Animal studies done in monkeys have not reported an increased chance of birth defects.  

Does taking ofatumumab in pregnancy increase the chance of other pregnancy-related problems?

 

Studies have not been done to see if ofatumumab increases the chance for pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). 

Animal studies have reported lower B-cell counts and reduced antibody response in offspring exposed to ofatumumab during pregnancy. Having a low number of B cells can increase the chance for infections.  

It is not known if using ofatumumab in pregnancy could increase the chance of infections in infants. In over 20 pregnancies exposed to ofatumumab, there were no reports of B-cell depletion, problems with antibodies or blood (immunoglobulin/hematological abnormalities), or serious infections in live births. 

Since some biologic medications might suppress the immune system of the person taking it, there is a theoretical concern that the same thing could happen to the baby if they are exposed during pregnancy. If someone has a weakened immune system they may be more likely to develop an infection from a live vaccine. Live vaccines contain a small amount of live virus. Inactivated vaccines do not contain live virus. In the United States, rotavirus is the only live vaccine routinely given in the first year of life.  

The product label for this drug recommends that infants who were exposed to ofatumumab during pregnancy should have their B-cell levels tested before receiving live vaccines. This is because having low B-cells may increase the chance of infection from live vaccines. Inactivated (not live) vaccines may be given to babies on schedule before B-cell levels are back to normal. However, ofatumumab may change how well inactivated vaccines work. Talk with your child’s healthcare provider about your exposure to ofatumumab during pregnancy. They can talk with you about the vaccines your child should receive and the best time for your child to receive them.  

Does taking ofatumumab in pregnancy affect future behavior or learning for the child?  

 

Studies have not been done to see if ofatumumab can cause behavior or learning issues for the child.  

Breastfeeding while taking ofatumumab:

 

There is limited information on the use of ofatumumab while breastfeeding. Ofatumumab is a large protein molecule, which means the amount that passes into breastmilk is expected to be low. Ofatumumab would likely break down in the infant’s intestinal tract, and the amount of medication absorbed into the infant is expected to be low. In one study where 12 mothers received ofatumumab, the amount of ofatumumab in their breast milk was small and no health effects were reported among the nursing infants. Be sure to talk to your healthcare provider about all of your breastfeeding questions.  

If a man takes ofatumumab, could it affect his fertility or increase the chance of birth defects?

 

Studies have not been done to see if ofatumumab could affect male fertility or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

MotherToBaby is currently conducting a study looking at ofatumumab and other medications used to treat multiple sclerosis in pregnancy. If you are interested in learning more about this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.

Please click here for references.

This sheet is about exposure to ibuprofen in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is ibuprofen? 

Ibuprofen is a medication that has been used to treat pain and fever. Some brand names for ibuprofen include Motrin®, Advil®, and Nuprin®. Ibuprofen belongs to the class of medications called non-steroidal anti-inflammatory drugs (NSAIDs).  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

The U.S. Food and Drug Administration (FDA) recommend not using NSAIDs after week 20 of pregnancy unless your healthcare provider specifically recommends it. If a healthcare provider decides NSAIDs are needed after week 20 of pregnancy, they should be used at the lowest dose for the shortest time.  

I take ibuprofen. Can it make it harder for me to get pregnant?  

It is not known if ibuprofen can make it harder to get pregnant. A few small studies have suggested using ibuprofen might increase the chance for unruptured follicle syndrome. This is when a follicle (small, fluid-filled sac in the ovary that holds an egg) does not release the egg at the time of ovulation. Unruptured follicle syndrome might make it harder to get pregnant. 

Does taking ibuprofen increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Some studies have suggested that the use of ibuprofen might increase the chance of miscarriage, especially if taken around the time of conception or over a long period of time. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition being treated, or other factors are the cause of a miscarriage. 

Does taking ibuprofen increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like ibuprofen, might increase the chance of birth defects in a pregnancy. There are several studies that have not reported an increased chance of birth defects with ibuprofen use. 

A few studies have suggested that taking ibuprofen in the first trimester might lead to a small increased chance (less than 1%, or 1 birth in 100 births) for gastroschisis (when the intestines stick out of a hole in the stomach wall).  

A small increased chance of heart defects has been reported in a few studies looking at NSAID prescriptions in early pregnancy. However, the reason the NSAID was prescribed was not available in most of the reported data. Studies based on prescription records cannot tell if a person took the medication. This makes it hard to know if the study outcomes are related to the medication or other factors.  

There is not enough information to confirm if ibuprofen increases the chance of birth defects. 

Does taking ibuprofen in pregnancy increase the chance of other pregnancy-related problems? 

There are some studies that suggest NSAIDs can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth. Other studies have not reported these findings.   

Ibuprofen is usually not recommended after week 20 of pregnancy. Some reports suggest that using NSAIDs in the second half of pregnancy might affect the fetal kidneys and lower the amount of amniotic fluid (the fluid around the fetus in the womb). One study also suggested that NSAID use earlier in pregnancy might have similar effects. Too little amniotic fluid (called oligohydramnios) can lead to problems like poor lung development, stiff joints, or the need for early delivery by induction or C-section. In rare cases, oligohydramnios could cause fetal death before birth. 

Using ibuprofen later in pregnancy might cause the ductus arteriosus (an opening between the two major blood vessels leading from the heart) to close early. If the ductus arteriosus closes before it should, it can cause high blood pressure in the fetal lungs (pulmonary hypertension).  

Ibuprofen should only be used under a healthcare provider’s supervision, particularly in the 2nd and 3rd trimesters. Your healthcare providers can closely monitor your pregnancy if you need to use ibuprofen after week 20 of pregnancy.  

Does taking ibuprofen in pregnancy affect future behavior or learning for the child?   

It is not known if ibuprofen can increase the chance of behavior or learning issues for the child. 

Breastfeeding while taking ibuprofen: 

Ibuprofen gets into breast milk in small amounts. The amount of ibuprofen in breast milk is less than the doses given to infants directly. When used as directed, side effects are not expected in children exposed to ibuprofen through breast milk. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes ibuprofen, could it affect fertility or increase the chance of birth defects? 

Some studies suggest ibuprofen could affect male fertility (ability to get a woman pregnant), and others do not. Studies have not been done to see if ibuprofen could increase the chance of birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.   

Please click here for references.