Human pregnancy safety for agents used to treat rheumatoid arthritis: adequacy of available information and strategies for developing post-marketing data

Table 2 Anti-inflammatory medications

Class	Agent	FDA pregnancy category	Adverse effects in human pregnancy	Summary risk assessment
Corticosteroids	Prednisone	C	Oral clefts increased risk (two- to three-fold). Intrauterine growth restriction (dose related)	Based on available data, teratogenic risk for corticosteroids is minimal
	Cortisone	D
	All others	C
NSAIDs	Celecoxib	C	Ibuprofen associated with increased risk (two- to three-fold) for gastroschisis. NSAIDs associated with increased risk for spontaneous abortion; possible increased risk for cardiac defects; premature closure of the ductus arteriosus with third trimester use	Significant risk for premature closure of the ductus arteriosus and other complications when exposure occurs in late pregnancy; minimal or undetermined risk for structural defects following first trimester exposure
	Diclofenac	C
	Ketorolac	C
	Prixicam	C
	All others	B
	All NSAIDs in third trimester	D