In utero aspirin exposure and child neurocognitive development: A propensity score‐matched analysis

Abstract

AbstractObjectiveTo evaluate the association between a short‐period, high‐dose in utero aspirin exposure and child neurocognitive development.DesignA propensity score‐matched analysis of a multicentre prospective cohort study.SettingThe US Collaborative Perinatal Project (1959–1976).PopulationA total of 50 565 singleton live births with maternal information.MethodsWe performed a propensity score matching to balance maternal characteristics between women with and without aspirin exposure. Inverse probability‐weighted marginal structural models were used to estimate associations between aspirin exposure and child neurocognitive assessments.Main outcome measuresChild neurocognitive development was assessed 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.ResultsChildren exposed to aspirin in utero were associated with an 8%–16% reduced risk of having suspect/abnormal or below‐average scores in most neurocognitive assessments. A trend of lower risks of having suspect/abnormal or below‐average scores was further observed in children with in utero aspirin exposure for more than 7 days, particularly on Bayley Mental (relative risk [RR] 0.82, 95% CI 0.74–0.92), WRAT Reading (RR 0.88, 95% CI 0.78–0.98) and WRAT Arithmetic tests (RR 0.76, 95% CI 0.66–0.86). This association was mainly observed in the second trimester of pregnancy.ConclusionsIn utero aspirin exposure was associated with improved child neurocognitive development in a prospective cohort study. Further studies are warranted to evaluate the impact of long‐period and low‐dose in utero aspirin exposure on child short‐ and long‐term neurodevelopment.