Low-Dose Aspirin in Pregnancy: Maternal and Neonatal Aspirin Concentrations and Neonatal Prostanoid Formation

Leonhardt, Andreas; Bernert, Stefanie; Watzer, Bernhard; Schmitz-Ziegler, Gabriele; Seyberth, Hannsjörg W.

doi:10.1542/peds.111.1.e77

Cited by 47 publications

(27 citation statements)

References 50 publications

(56 reference statements)

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“…2 Aspirin given to the mother in high-risk pregnancies may cross the placenta. 3 Aspirin is well tolerated by the fetus and seems to produce a moderate reduction of several different risks (preeclampsia, delivery before 37 weeks of gestation, and fetal growth restriction) without increasing infant bleeding. 4 Nevertheless, the long-term effects of aspirin on preterm children are unknown.…”

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confidence: 99%

Prenatal Low-Dose Aspirin and Neurobehavioral Outcomes of Children Born Very Preterm

et al. 2010

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WHAT'S KNOWN ON THIS SUBJECT:Aspirin given to the mother in high-risk pregnancies seems to produce a moderate reduction of several different risks such as preeclampsia; delivery before 37 weeks of gestation; and fetal growth restriction. WHAT THIS STUDY ADDS:A low dose of prenatal aspirin treatment was not associated with adverse neonatal or long-term outcomes.abstract OBJECTIVE: Low-dose aspirin (LDA) given during pregnancy may alter brain development in very preterm infants. We report the short-and long-term outcomes of very preterm infants according to LDA treatment. PATIENTS AND METHODS: Data were from the Etude Epidemiologique des Petites Ages Gestationnels (EPIPAGE) cohort study, which included all infants born before 33 weeks of gestation in 9 French regions in 1997. This study was restricted to 656 children who were born to 584 women with an obstetric history of placental vascular disease or with chronic hypertension or renal or autoimmune diseases. The main outcome measures were mortality, cerebral lesions, and outcome at 5 years of age, which were measured by a diagnosis of cerebral palsy; behavioral difficulties, which were assessed with the Strength and Difficulties Questionnaire; and cognitive impairment, which was measured by the mental processing composite scale of the Kaufman Assessment Battery for Children (an IQ-equivalent measure of cognitive ability in 2 dimensions: sequential and simultaneous processing scores). RESULTS: LDA treatment was administered to 125 of 584 (21%) mothers and was not significantly associated with mortality, cerebral lesions, cerebral palsy, or global cognitive impairment of the children at 5 years of age. The proportion of low simultaneous processing scores (Ͻ70) was lower in the group with LDA (7% vs 19% without LDA; P ϭ .04). This association was not significant after adjustment for propensity score, prognostic factors, and social class (adjusted odds ratio [aOR] Learning to protect the preterm brain is a challenging priority in view of the disturbingly high rate of long-term neurosensory, cognitive, and behavioral disabilities in very preterm infants. 1 A large number of studies have examined the multifactorial origin of cerebral lesions (subependymal/intraventricular hemorrhages [SEH/IVH]) and white matter injuries [WMIs]) and later neurodisabilities, which involve acute/subacute ischemic/inflammatory antenatal or perinatal events combined with deprivation of placental hormonal or growth factors caused by preterm birth. 2 Aspirin given to the mother in high-risk pregnancies may cross the placenta. 3 Aspirin is well tolerated by the fetus and seems to produce a moderate reduction of several different risks (preeclampsia, delivery before 37 weeks of gestation, and fetal growth restriction) without increasing infant bleeding. 4 Nevertheless, the long-term effects of aspirin on preterm children are unknown. Aspirin inhibits cyclooxygenase 1 (COX 1) and COX 2. Because COX 2 plays a role in the dendritic arborization involved in the developing areas that are responsible...

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Prenatal Low-Dose Aspirin and Neurobehavioral Outcomes of Children Born Very Preterm

et al. 2010

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“…Although aspirin does not appear to alter the risk of congenital anomalies, first trimester aspirin consumption may increase the incidence of gastroschisis [30]. Acetylsalicylic acid may reach the uteroplacental circulation and exert antiplatelet effects in the fetus and newborn, although the incidence of neonatal bleeding does not appear to be increased with maternal aspirin [31,32]. However, maternal aspirin may raise the risk of placental abruption and antenatal, intrapartum, and postpartum hemorrhage [32,33].…”

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confidence: 99%

Low-dose aspirin does not improve ovarian stimulation, endometrial response, or pregnancy rates for in vitro fertilization

Hurst

Bhojwani

Marshburn

et al. 2005

J Exp Clin Assist Reprod

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BackgroundThe purpose of this study is to determine if low-dose aspirin improved ovarian stimulation, endometrial response, or IVF pregnancy rates in our program.MethodsRetrospective analysis of 316 consecutive IVF cycles from 1995 through 2001. Aspirin 80 mg daily was initiated at the start of luteal leuprolide in 72 cycles. The 244 controls received no aspirin during treatment.ResultsThe live birth rate in aspirin users was 29%, slightly lower compared to 41% in the no aspirin control group (p = 0.07). Implantation rates were 21% with aspirin and 30% in the control population (p = 0.01). There was no difference in the maximal endometrial thickness between aspirin and non-aspirin groups. The two groups were similar regarding age, gonadotropin ampules, embryos, number of embryos transferred, prior parity, diagnosis, use of intracytoplasmic sperm injection, and stimulation protocol.ConclusionLow-dose aspirin was not beneficial to IVF patients in our program. Aspirin does not enhance endometrial thickness, augment the ovarian response, or improve pregnancy rates.

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“…Aspirin has the ability to cross the placenta 35 , and when taken in low doses, it appears to reduce the risk of preeclampsia 36 without adversely affecting the fetus 37 . In the ELGAN Study cohort, mother’s consumption of aspirin was also associated with an increased risk of quadriparetic cerebral palsy 38 .…”

Section: Discussionmentioning

confidence: 99%

Antecedents and correlates of visual field deficits in children born extremely preterm

Holm

Msall

Skranes

et al. 2015

European Journal of Paediatric Neurology

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Aim We sought to identify the antecedents and correlates of visual field deficits (VFDs) at age 2 years among infants born before the 28th week of gestation. Methods The visual fields of 1023 infants were assessed by confrontation at age 2 years. We compared the ante-and postnatal characteristics and exposures of the 65 infants with a VFD to their peers who did not have a VFD. We used time-oriented logistic regression risk models to assess the associations of potential antecedents and correlates with a VFD. Results In the final regression model, VFD was associated with maternal consumption of aspirin during the current pregnancy, recurring/persistent acidemia during the first 3 postnatal days, cerebral ventriculomegaly seen on neonatal ultrasound, prethreshold retinopathy of prematurity (ROP), and supplemental oxygen and ventilator dependence at 36 weeks post-menstrual age. Birth before the 27th week was also associated with increased risk, but its significance was diminished by the addition of postnatal variables. Conclusion In this sample of extremely preterm born infants, antenatal as well as early and late postnatal characteristics and exposures are associated with an increased risk of having a VFD. Our study adds to our knowledge about the complex etiology of visual deficits of prematurity, and supports a multifactorial cause of these deficits.

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Low-Dose Aspirin in Pregnancy: Maternal and Neonatal Aspirin Concentrations and Neonatal Prostanoid Formation

Abstract: In pregnant women who are treated with LDA, acetylsalicylic acid is not completely inactivated in the portal circulation but reaches the uteroplacental circulation and exerts antiplatelet effects in the fetus and newborn.

Cited by 47 publications

References 50 publications

Prenatal Low-Dose Aspirin and Neurobehavioral Outcomes of Children Born Very Preterm

Prenatal Low-Dose Aspirin and Neurobehavioral Outcomes of Children Born Very Preterm

Low-dose aspirin does not improve ovarian stimulation, endometrial response, or pregnancy rates for in vitro fertilization

Antecedents and correlates of visual field deficits in children born extremely preterm

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