Zhu J, Gan Y, Yang C, Gu W, Wang Y, Zhang J, Liu Z. In utero aspirin exposure and child neurocognitive development: A propensity score-matched analysis.
BJOG 2024;
131:1630-1639. [PMID:
38808468 DOI:
10.1111/1471-0528.17871]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/11/2024] [Accepted: 05/13/2024] [Indexed: 05/30/2024]
Abstract
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.
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