Brain damage in preterm newborns and maternal medication: the ELGAN Study

Area of Science:

• Perinatal medicine
• Neurodevelopmental disorders
• Pharmacology in pregnancy

Background:

• Cerebral palsy (CP) is a significant concern in very preterm infants.
• Understanding factors contributing to CP is crucial for prevention and intervention.
• Maternal medication use during pregnancy is a potential modifiable risk factor.

Purpose of the Study:

• To investigate the association between maternal medication use during pregnancy and cerebral white matter damage.
• To evaluate the link between maternal medication use and the development of cerebral palsy (CP) in very preterm infants.

Main Methods:

• Analysis of data from 877 infants born before 28 weeks' gestation (Extremely Low Gestational Age Newborns Study).
• Maternal interviews, chart reviews, placental assessments, and infant evaluations at 24 months corrected age.
• Neurologic findings classified using a diagnostic algorithm for CP subtypes.

Main Results:

• Maternal aspirin use was associated with an elevated risk of quadriparetic CP (OR, 3.0; 95% CI, 1.3-6.9).
• Maternal nonsteroidal anti-inflammatory drug (NSAID) use was linked to increased risk of quadriparetic CP (OR, 2.4; 95% CI, 1.04-5.8).
• Unapproved NSAID use by mothers was associated with diparetic CP (OR, 3.5; 95% CI 1.1-11.0).

Conclusions:

• The study suggests a possible link between maternal aspirin and NSAID use and perinatal brain damage.
• The findings indicate that these medications may contribute to the development of CP in very preterm infants.
• Further research is warranted to confirm these associations and explore underlying mechanisms.