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

Am J Obstet Gynecol. 2012 Sep;207(3):192.e1-9. doi: 10.1016/j.ajog.2012.06.059. Epub 2012 Jul 7.


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Brain Injury, Chronic / chemically induced*
  • Cerebral Palsy / chemically induced*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / chemically induced*
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Prenatal Exposure Delayed Effects / chemically induced*
  • Prospective Studies
  • Young Adult