JAMA Pediatr

Gestational NSAID exposure tied to increased risk of childhood CKD

January 8, 2025

Study details: This cohort study analyzed data from 1,025,255 children born in Taiwan between January 1, 2007, and December 31, 2017, with follow-up until December 31, 2021. The study included 163,516 singleton-born children whose mothers used ≥1 NSAID during pregnancy. The primary outcome was the incidence of chronic kidney disease (CKD) in childhood.

Results: A significant association was found between gestational NSAID exposure and an increased risk of childhood CKD, with a weighted hazard ratio (wHR) of 1.10. Increased risks were observed for NSAID exposure during the second and third trimesters (wHRs of 1.19 and 1.12, respectively). Specific NSAIDs associated with elevated CKD risk included indomethacin and ketorolac in the first trimester, diclofenac and mefenamic acid in the second trimester, and ibuprofen in the third trimester. However, no association was seen in sibling comparisons.

Clinical impact: These findings suggest that NSAID use during pregnancy may increase the risk of CKD in offspring. The risks and benefits of prescribing NSAIDs to pregnant patients should be carefully considered and potential kidney issues in children with prenatal NSAID exposure should be monitored.

Source:

Tain YL, et al. (2024, December 23). JAMA Pediatr. Gestational Exposure to Nonsteroidal Anti-Inflammatory Drugs and Risk of Chronic Kidney Disease in Childhood. https://pubmed.ncbi.nlm.nih.gov/39714827/