Effect of in Utero Aspirin Exposure on Neurocognitive Development of Children

The present multicentre prospective cohort study assessed the relationship between a short-period, high-dose in utero aspirin exposure and child neurocognitive development. The study included a total of 50 565 singleton live births with maternal information.

The study utilized propensity score matching to balance maternal characteristics between women who were exposed to aspirin and those who were not. Inverse probability-weighted marginal structural models were employed to evaluate the relationship between aspirin exposure and neurocognitive assessments in children. The main outcome measures included child neurocognitive development, which was assessed at various ages 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.

The results indicated the following:

• Children who were exposed to aspirin in utero exhibited an 8% to 16% lower risk of being classified with suspect/abnormal or below-average scores on most neurocognitive assessments. 
• Furthermore, a trend towards reduced risks for having suspect/abnormal or below-average scores was noted in children exposed to aspirin for more than 7 days in utero, particularly on the Bayley Mental scale (relative risk [RR] 0.82), WRAT Reading (RR 0.88), and WRAT Arithmetic tests (RR 0.76). 
• This association was predominantly observed during the second trimester of pregnancy.
• Conclusions

Thus, the study concluded that found that in utero exposure to aspirin is linked to better neurocognitive development in children. Additional research is needed to assess the effects of prolonged and low-dose in utero aspirin exposure on both short- and long-term neurodevelopment in children.

Source: 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 Nov;131(12):1630-1639. doi: 10.1111/1471-0528.17871. Epub 2024 May 29. PMID: 38808468.