Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
Am J Obstet Gynecol. 2012 Sep;207(3):192.e1-9. doi: 10.1016/j.ajog.2012.06.059. Epub 2012 Jul 7.
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.
我们旨在评估孕妇在怀孕期间用药与极早产儿脑白质损伤和脑瘫（CP）之间的关联。
本项对来自极低胎龄新生儿（ELGAN）研究的数据进行了分析，纳入了 877 名胎龄<28 周的婴儿。对母亲进行了访谈、查阅了病历、培养并对胎盘进行了组织学评估，且在 24 个月的校正年龄时对儿童进行了评估。一个诊断算法将神经学发现分类为四肢瘫 CP、双瘫 CP、偏瘫 CP 或无 CP。
在调整了可能因用药而引起的疾病的混杂因素后，母亲服用阿司匹林（比值比 [OR]，3.0；95%置信区间 [CI]，1.3-6.9）和非甾体抗炎药（NSAIDs）（OR，2.4；95% CI，1.04-5.8）的婴儿四肢瘫 CP 的风险仍然升高。双瘫 CP 的风险也与母亲使用 NSAID 相关，但前提是这种使用未得到医生的批准（OR，3.5；95% CI，1.1-11.0）。
不能排除孕妇在怀孕期间使用阿司匹林和 NSAID 可能导致围产期脑损伤的可能性。
