Tuesday, December 22, 2009
The children of women who take low-dose aspirin during pregnancy because they are at high risk for delivering prematurely may have fewer behavioral problems at age 5, new research suggests.
Obstetricians occasionally give low-dose aspirin to pregnant women who are suitable to have such complications as fetal growth restriction (when a fetus doesn't grow properly in the womb) or preeclampsia (high Blood Pressure (BP) that is dangerous to both mother and the fetus), said Dr. Ashley Roman, a clinical assistant professor of obstetrics and gynecology at NYU Langone Medical Center. Roman was not involved in the research.
In the study, French researchers used data on 656 children born by 33 weeks of gestation to 584 women from 9 regions in France. A full-term birth is at 40 weeks' gestation. The women had a history of placental vascular disease, fetal growth restriction, chronic hypertension, and renal or autoimmune diseases.
About 21 % of the women took low-dose aspirin during pregnancy.
At the age of 5, children whose mother had taken aspirin were slightly less likely to have behavioral difficulties or hyperactivity, though the outcome was not statistically significant, according to the study.
As well, the babies whose mothers had taken aspirin faced no increased risk for death, cerebral lesions or cerebral palsy.
One of the fears of giving aspirin to women during pregnancy is that aspirin interferes with platelet function, which is essential for blood clotting. Because of that, it may possibly raise the risk for brain bleeds in already susceptible premature infants, Roman said. The study found no increase in the risk for brain bleeds.
"This study is important as it helps reassure both us as the physician and patients that giving low-dose aspirin is not associated with a higher risk of problems in the baby," Roman said. "Not only is it not associated with problems right after the baby is born, but it is not associated with problems down the road."
The study findings are published online December 21 and in the January print issue of the journal Pediatrics.
Still, much remains unknown about the role of aspirin in pregnancy, including exactly how well or why aspirin works, Roman noted. One theory is that fetal growth restriction might be caused by tiny blood clots in the placenta, and aspirin helps blood flow between the placenta and the fetus. Low-dose aspirin is also taken by adult men and women at risk for heart attack and stroke.
Dr. Michael Katz, the senior vice president for research and global programs at the March of Dimes, said the study is interesting, but the findings are too preliminary to be of much help to women or their physicians. Lots of women in the study were also given other drugs, including corticosteroids, and it is unknown how much that affected the outcomes.
"Aspirin is quite a remarkable drug, acting as an anti-inflammatory and interfering with platelet function to stop clotting," Katz said. "But how that translates into helping fetuses may be beyond speculation at this point."
"Behavioral difficulties," as cited in the study, is a broad term that can encompass the whole thing from excessive temper tantrums to learning disabilities to hyperactivity to autism, he said, each of which can have very different underlying causes.
"It is hard to imagine a single intervention [aspirin] will deal with hyperactivity and all of those neurobehavioral problems," Katz said.
Still, he added, the findings are worth following up. "Anything you can do to help premature babies is worth pursuing because, for many, it's a desperate situation," Katz said. "And if they are right, it is a very inexpensive way of dealing with it."
Premature children's are at higher risk for neurological problems, including learning disabilities, cerebral palsy, and hearing and vision problems.
