Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Exposure to maternal acetylsalicylic acid and the risk of bleeding events in extreme premature neonates

Journal of Perinatology (2023)Cite this article

Subjects

Acetylsalicylic acid (ASA) is commonly prescribed prior to 16 weeks of gestation for prophylaxis of maternal preeclampsia, a condition increasing the risk of delivering preterm [1]. Preeclampsia is a serious hypertensive disorder affecting mothers and is associated with various neonatal complications [1]. ASA has anti-platelet aggregation properties and could possibly increase the risk of bleeding events in mothers and their offspring due to the crossing of the placenta [2]. Indeed, ASA is not fully inhibited when reaching the uteroplacental circulation and thus does enter fetal circulation [2]. Specifically, ASA seems to have an inhibitory effect on platelet Thromboxane xA2 formation [2]. A previous population-based study reported a potential risk of intracranial hemorrhage in term neonates, with an incidence of 0.07% amongst those exposed to maternal ASA compared to 0.01% among those non-exposed (adjusted OR, 9.66; 95% CI, 1.88–49.48) [1]. Information on the association between maternal ASA and significant bleeding events, such as intraventricular hemorrhage (IVH) grade ≥3 or pulmonary hemorrhage (PH), in extremely preterm infants is lacking. Thus, we sought to investigate the association between maternal ASA exposure and significant IVH or PH, among infants born at <29 weeks of estimated gestational age.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Data availability

Derived data generated will be shared on reasonable request to the corresponding author.

References

  1. Hastie R, Tong S, Wikström AK, Sandström A, Hesselman S, Bergman L. Aspirin use during pregnancy and the risk of bleeding complications: a Swedish population-based cohort study. Am J Obstet Gynecol. 2021;224:95.e91–5.e12.

    Article  Google Scholar 

  2. Leonhardt A, Bernert S, Watzer B, Schmitz-Ziegler G, Seyberth HW. Low-dose aspirin in pregnancy: maternal and neonatal aspirin concentrations and neonatal prostanoid formation. Pediatrics. 2003;111:e77–81.

    Article  PubMed  Google Scholar 

  3. Mitsiakos G, Papathanasiou AE, Kyriakidis I, Karagianni P, Tsepis K, Tzimou I, et al. Intraventricular hemorrhage and platelet indices in extremely premature neonates. J Pediatr Hematol Oncol. 2016;38:533–8.

    Article  PubMed  Google Scholar 

  4. McCauley KE, Carey EC, Weaver AL, Mara KC, Clark RH, Carey WA, et al. Survival of ventilated extremely premature neonates with severe intraventricular hemorrhage. Pediatrics. 2021;147:e20201584.

    Article  PubMed  Google Scholar 

Download references

Funding

This project was supported by the Department of Pediatrics of McGill University and the Just for Kids Foundation. Funder/sponsor did not participate in the work.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Neonatology, Montreal Children’s Hospital, McGill University Health Centre, McGill University, Montreal, QC, Canada

    Justine Morin, Gabriela De Carvalho Nunes, Jessica Simoneau, Marc Beltempo & Gabriel Altit

  2. Department of Pediatrics, Hematology-Oncology, Montreal Children’s Hospital, McGill University Health Centre, McGill University, Montreal, QC, Canada

    Joanne Delaney & Catherine Goudie

  3. Department of Medicine, General Internal Medicine, McGill University Health Centre, McGill University, Montreal, QC, Canada

    Isabelle Malhamé

Authors
  1. Justine Morin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joanne Delaney
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gabriela De Carvalho Nunes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jessica Simoneau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marc Beltempo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Catherine Goudie
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Isabelle Malhamé
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gabriel Altit
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JM conceptualized and designed the study, collected the data, analyzed the data, drafted the manuscript, and adjusted the manuscript according to the comments of the co-authors. JD conceptualized and designed the study, collected the data, analyzed the data, drafted the manuscript, and adjusted the manuscript according to the comments of the co-authors. GDCN collected the data, critically appraised the analysis, and revised the manuscript. JS collected the data, critically appraised the analysis, and revised the manuscript. MB critically appraised the analysis of the data, and reviewed and revised the manuscript. CG critically appraised the analysis of the data, and reviewed and revised the manuscript. IM conceptualized and designed the study, critically appraised the analysis of the data, and reviewed and revised the manuscript. GA conceptualized and designed the study, supervised data collection, critically appraised the analysis of the data, and wrote and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Gabriel Altit.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morin, J., Delaney, J., Nunes, G.D.C. et al. Exposure to maternal acetylsalicylic acid and the risk of bleeding events in extreme premature neonates. J Perinatol (2023). https://doi.org/10.1038/s41372-023-01644-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41372-023-01644-1

Search

Advanced search

Quick links