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为妊娠妇女及乳母处方非甾体抗炎药时,应谨慎权衡利弊。非甾体抗炎药作为前列腺素合成抑制剂可致凝血功能异常、子宫动脉导管收缩并延长产程。水杨酸盐对动物可致畸,但尚缺乏使人致畸的依据。孕妇使用阿司匹林可致分娩时及产前、产后出血,并致新生儿患出血性疾病。一般认为吲哚美辛对胎儿的循环有影响并能致畸,但也尚有争议。而萘普生对胎儿的循环、凝血以及肾脏功能均有影响。布洛芬、保泰松也可引起先天性缺损。因此,该类药物一般应避免使用于妊娠妇女。从物理、化学性质,药动学方面看,虽然大部分非甾体抗炎药在乳汁中的排泌率低,对乳儿的影响不大,但吲哚美辛由于半衰期长、代谢物仍有活性,乳母使用可能会使乳儿发生不良反应。而乳儿发生水杨酸盐毒性反应早有报道。乳儿肝肾功能未健全,乳母阿司匹林用量的21％又可通过乳汁被乳儿摄入,水杨酸盐应为乳母的禁忌药物。
For pregnant women and nursing mothers prescribing non-steroidal anti-inflammatory drugs, should be carefully weighed pros and cons. Non-steroidal anti-inflammatory drugs as prostaglandin synthesis inhibitors can cause coagulation disorders, uterine artery catheter contraction and prolong labor process. Salicylates can cause teratogenicity on animals, but the lack of teratogenic basis. Pregnant women using aspirin can cause childbirth and prenatal, postpartum hemorrhage, and neonatal hemorrhagic disease. It is generally believed that indomethacin affects the fetus’s circulation and can cause teratogenicity, but it is still debatable. The naproxen on fetal circulation, coagulation and renal function are affected. Ibuprofen, phenylbutazone can also cause congenital defects. Therefore, such drugs should generally be avoided for pregnant women. In terms of physical, chemical and pharmacokinetics, although most non-steroidal anti-inflammatory drugs have low excretion rate in milk and little effect on infants, indomethacin still has metabolites due to its long half-life Activity, lactating maternal use may cause adverse reactions. Salicylate salivary toxicity occurred in infants reported earlier. Infant liver and kidney function is not perfect, 21% of the amount of lactating aspirin can be ingested by the baby milk, salicylate should be taboo drugs for the nurse.