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

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• 作者：Crystal P. Tyler ; PhD^a ; ^{ctyler@cdc.gov} ; Nigel Paneth ; MD^a ; ^b ; Elizabeth N. Allred ; MS^c ; Deborah Hirtz ; MD^f ; Karl Kuban ; MD^d ; Thomas McElrath ; MD^e ; T. Michael O'Shea ; MD^g ; Cindy Miller ; MD^h ; Alan Leviton ; MD^c ; ELGAN Study Investigators
• 关键词：cerebral palsy ; cerebral white matter damage ; preterm
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2012
• 出版时间：September, 2012
• 年：2012
• 卷：207
• 期：3
• 页码：192.e1-192.e9
• 全文大小：310 K

文摘

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Objective

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.

Study Design

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.

Results

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).

Conclusion

The possibility that aspirin and NSAID use in pregnancy could lead to perinatal brain damage cannot be excluded.