{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:55:04Z","timestamp":1793386504788,"version":"4.5.0"},"reference-count":47,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T00:00:00Z","timestamp":1651449600000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"EU Horizon 2020","award":["825100"],"award-info":[{"award-number":["825100"]}]},{"name":"MRC Centre for Reproductive Health","award":["MR\/N022556\/1"],"award-info":[{"award-number":["MR\/N022556\/1"]}]},{"DOI":"10.13039\/501100000268","name":"Biotechnology and Biological Sciences Research Council","doi-asserted-by":"publisher","award":["1942576"],"award-info":[{"award-number":["1942576"]}],"id":[{"id":"10.13039\/501100000268","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,4,7]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To identify any associations between in utero exposure to five over-the-counter (non-prescription) analgesics (paracetamol, ibuprofen, aspirin, diclofenac, naproxen) and adverse neonatal outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective cohort study using the Aberdeen Maternity and Neonatal Databank.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>151\u2009141 singleton pregnancies between 1985 and 2015.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Premature delivery (&lt;37 weeks), stillbirth, neonatal death, birth weight, standardised birthweight score, neonatal unit admission, APGAR score at 1 and 5\u2009min, neural tube and amniotic band defects, gastroschisis and, in males, cryptorchidism and hypospadias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>83.7% of women taking over-the-counter analgesics reported first trimester use when specifically asked about use at their first antenatal clinic visit. Pregnancies exposed to at least one of the five analgesics were significantly independently associated with increased risks for premature delivery &lt;37 weeks (adjusted OR (aOR)=1.50, 95%\u2009CI 1.43 to 1.58), stillbirth (aOR=1.33, 95%\u2009CI 1.15 to 1.54), neonatal death (aOR=1.56, 95%\u2009CI 1.27 to 1.93), birth weight &lt;2500\u2009g (aOR=1.28, 95%\u2009CI 1.20 to 1.37), birth weight &gt;4000\u2009g (aOR=1.09, 95%\u2009CI 1.05 to 1.13), admission to neonatal unit (aOR=1.57, 95%\u2009CI 1.51 to 1.64), APGAR score &lt;7 at 1\u2009min (aOR=1.18, 95%\u2009CI 1.13 to 1.23) and 5\u2009min (aOR=1.48, 95%\u2009CI 1.35 to 1.62), neural tube defects (aOR=1.64, 95%\u2009CI 1.08 to 2.47) and hypospadias (aOR=1.27, 95%\u2009CI 1.05 to 1.54 males only). The overall prevalence of over-the-counter analgesics use during pregnancy was 29.1%, however it rapidly increased over the 30-year study period, to include over 60% of women in the last 7\u2009years of the study. This makes our findings highly relevant to the wider pregnant population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Over-the-counter (non-prescription) analgesics consumption during pregnancy was associated with a substantially higher risk for adverse perinatal health outcomes in the offspring. The use of paracetamol in combination with other non-steroidal anti-inflammatory drugs conferred the highest risk. The increased risks of adverse neonatal outcomes associated with non-prescribed, over-the-counter, analgesics use during pregnancy indicate that healthcare guidance for pregnant women regarding analgesic use need urgent updating.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-048092","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T11:38:07Z","timestamp":1651577887000},"page":"e048092","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Maternal over-the-counter analgesics use during pregnancy and adverse perinatal outcomes: cohort study of 151\u2009141 singleton pregnancies"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3851-7948","authenticated-orcid":false,"given":"Aikaterini","family":"Zafeiri","sequence":"first","affiliation":[{"name":"Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin Amalraj","family":"Raja","sequence":"additional","affiliation":[{"name":"Medical Statistics Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rod Thomas","family":"Mitchell","sequence":"additional","affiliation":[{"name":"MRC Centre for Reproductive Health, The Queen\u2019s Medical Research Institute, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C","family":"Hay","sequence":"additional","affiliation":[{"name":"MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2358-5860","authenticated-orcid":false,"given":"Sohinee","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Women\u2019s Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A","family":"Fowler","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"2025101810154845000_12.5.e048092.1","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s00228-008-0611-6","article-title":"Health care providers\u2019 requests to teratogen information services on medication use during pregnancy and lactation","volume":"65","author":"Gendron","year":"2009","journal-title":"Eur J Clin Pharmacol"},{"key":"2025101810154845000_12.5.e048092.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.02.029"},{"key":"2025101810154845000_12.5.e048092.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.02.100"},{"key":"2025101810154845000_12.5.e048092.4","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.223"},{"key":"2025101810154845000_12.5.e048092.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004365"},{"key":"2025101810154845000_12.5.e048092.6","doi-asserted-by":"crossref","unstructured":"Zafeiri A , Mitchell RT , Hay DC . 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