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Published on: August 25, 2014
In utero aspirin exposure and child neurocognitive development: A propensity score-matched analysis
Jing Zhu1,2, Yuexin Gan1,2, Cuiping Yang1,2
1The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
In utero aspirin exposure, particularly in the second trimester, was linked to a reduced risk of neurocognitive deficits in children. These findings suggest potential benefits for child development from prenatal aspirin use.
Area of Science:
- Perinatal Medicine
- Developmental Neuroscience
- Pediatric Health
Background:
- Prenatal exposure to medications can influence child neurocognitive development.
- Aspirin is commonly used during pregnancy, but its long-term effects on child neurodevelopment require further investigation.
Purpose of the Study:
- To evaluate the association between short-period, high-dose in utero aspirin exposure and child neurocognitive development.
- To assess the impact of prenatal aspirin use on various neurocognitive outcomes in children.
Main Methods:
- A propensity score-matched analysis of a multicentre prospective cohort study involving 50,565 singleton live births from the US Collaborative Perinatal Project (1959-1976).
- Inverse probability-weighted marginal structural models were employed to estimate associations between aspirin exposure and neurocognitive assessments.
- Child neurocognitive development was assessed using the Bayley Scales, Stanford Binet Intelligence Scale, Wechsler Intelligence Scale, and Wide-Range Achievement Test (WRAT).
Main Results:
- In utero aspirin exposure was associated with an 8%-16% reduced risk of suspect/abnormal or below-average scores in most neurocognitive assessments.
- A trend of lower risks was observed with exposure longer than 7 days, particularly on Bayley Mental, WRAT Reading, and WRAT Arithmetic tests.
- These associations were predominantly observed with exposure during the second trimester of pregnancy.
Conclusions:
- In utero aspirin exposure demonstrated an association with improved child neurocognitive development.
- Further research is needed to explore the effects of long-period and low-dose prenatal aspirin exposure on child neurodevelopment.
Objective:
To evaluate the association between a short-period, high-dose in utero aspirin exposure and child neurocognitive development.
Design:
A propensity score-matched analysis of a multicentre prospective cohort study.
Setting:
The US Collaborative Perinatal Project (1959-1976).
Population:
A total of 50 565 singleton live births with maternal information.
Methods:
We performed a propensity score matching to balance maternal characteristics between women with and without aspirin exposure. Inverse probability-weighted marginal structural models were used to estimate associations between aspirin exposure and child neurocognitive assessments.
Main Outcome Measures:
Child neurocognitive development was assessed using the Bayley Scales at 8 months, the Stanford Binet Intelligence Scale at 4 years, and the Wechsler Intelligence Scale and Wide-Range Achievement Test (WRAT) at 7 years.
Results:
Children exposed to aspirin in utero were associated with an 8%-16% reduced risk of having suspect/abnormal or below-average scores in most neurocognitive assessments. A trend of lower risks of having suspect/abnormal or below-average scores was further observed in children with in utero aspirin exposure for more than 7 days, particularly on Bayley Mental (relative risk [RR] 0.82, 95% CI 0.74-0.92), WRAT Reading (RR 0.88, 95% CI 0.78-0.98) and WRAT Arithmetic tests (RR 0.76, 95% CI 0.66-0.86). This association was mainly observed in the second trimester of pregnancy.
Conclusions:
In utero aspirin exposure was associated with improved child neurocognitive development in a prospective cohort study. Further studies are warranted to evaluate the impact of long-period and low-dose in utero aspirin exposure on child short- and long-term neurodevelopment.
