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

Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
American journal of obstetrics and gynecology (Impact Factor: 3.97). 09/2012; 207(3):192.e1-9. DOI: 10.1016/j.ajog.2012.06.059
Source: PubMed

ABSTRACT We sought to evaluate the association between maternal medication use during pregnancy and cerebral white matter damage and cerebral palsy (CP) among very preterm infants.
This analysis of data from the Extremely Low Gestational Age Newborns (ELGAN) Study included 877 infants born <28 weeks' gestation. Mothers were interviewed, charts were reviewed, placentas were cultured and assessed histologically, and children were evaluated at 24 months corrected age. A diagnostic algorithm classified neurologic findings as quadriparetic CP, diparetic CP, hemiparetic CP, or no CP.
After adjustment for the potential confounding of disorders for which medications might have been indicated, the risk of quadriparetic CP remained elevated among the infants of mothers who consumed aspirin (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.3-6.9) and nonsteroidal antiinflammatory drugs (NSAIDs) (OR, 2.4; 95% CI, 1.04-5.8). The risk of diparetic CP was also associated with maternal consumption of an NSAID, but only if the consumption was not approved by a physician (OR, 3.5; 95% CI 1.1-11.0).
The possibility that aspirin and NSAID use in pregnancy could lead to perinatal brain damage cannot be excluded.

Download full-text


Available from: Crystal P Tyler, Feb 24, 2014
1 Follower
  • American journal of obstetrics and gynecology 11/2012; 208(2). DOI:10.1016/j.ajog.2012.11.022 · 3.97 Impact Factor
  • American journal of obstetrics and gynecology 11/2012; 208(2). DOI:10.1016/j.ajog.2012.11.024 · 3.97 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: 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. 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. 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. 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. Copyright © 2014. Published by Elsevier Ltd.
    European journal of paediatric neurology: EJPN: official journal of the European Paediatric Neurology Society 10/2014; 19(1). DOI:10.1016/j.ejpn.2014.10.002 · 1.93 Impact Factor
Show more