Vital Considerations for Aspirin in Prevention of Preeclampsia, a Multifaceted Pregnancy Disorder

To the Editor Preterm birth increases risk of neurodevelopmental delays. High-risk pregnancies for preeclampsia development are at increased risk of preterm birth, the rate of which is dependent on the definitions and screening criteria. Voutetakis et al raise concern of a potential long-term effect of aspirin given to prevent preterm preeclampsia in high-risk pregnancies owing to disruption of cyclooxygenase (COX) 2 and prostaglandin-E2 (PGE2) signaling, potentially affecting prenatal and postnatal brain development with subsequent neurodevelopmental impairments. There are some considerations for this argument. Several prior studies have shown that prophylactic use of low-dose aspirin (LDA) during pregnancy has no negative association with perinatal morbidity and mortality. Aspirin, particularly at low dose, is less effective at inhibiting COX2, an inducible enzyme, as opposed to COX1, a constitutive enzyme. The few studies in murine models that investigated the COX2/PGE2 pathway in brain and neurodevelopment only considered COX2-deficient knock-in rodents, ie, selective inhibition of COX2 as opposed to a dose-response effect of aspirin, an effect that might also be tissue dependent. In assessment of 5-year neurodevelopmental outcomes of children born preterm (22-32 weeks of gestation) using the Etude Epidemiologique des Petites Ages Gestationnels cohort study, prenatal LDA was not associated with adverse neonatal or long-term outcomes. The data also suggest LDA may even red...
Source: JAMA Pediatrics - Category: Pediatrics Source Type: research

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DiscussionThis umbrella review of associations between maternal prenatal use of analgesic drugs and children ’s neurodevelopmental disorders could allow for firmer conclusions to be drawn through the synthesis of all relevant published research. The synthesis of findings using high-quality evidence could provide more accurate healthcare information on the long-term effects of analgesic drugs on neurodeve lopment, to better guide future clinical decisions during pregnancy. This review will also allow gaps and methodological differences in the literature to be identified, informing recommendations for future research.S...
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
This study shed light on risk and protective factors associated with ASD in the Lebanese population. Further rigorous research, taking into consideration these factors, is needed to assist in early detection, prevention and subsequent intervention targeting ASD and its associated comorbidities, given that our study is not experimental and does not prove causality.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
This article reviewed the results of 21 recent meta-analyses examining the relationship between maternal use of antidepressants during pregnancy and negative outcomes in newborns and children. PubMed was searched for meta-analyses published in English between January 1, 2011, and November 30, 2019, by using combinations of the keywords pregnancy, antidepressants, review, meta-analysis, selective serotonin reuptake inhibitors, selective serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, neonatal outcomes, autism spectrum disorders, attention deficit hyperactivity disorder (ADHD), preterm birth, low bir...
Source: The Journal of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: J Clin Pharmacol Source Type: research
Women who use cannabis while pregnant have an elevated risk of having children with autism spectrum disorder (ASD), according to astudy published today inNature Medicine.“Children with prenatal cannabis exposure had an increase of 50% in the risk of an autism diagnosis over the study period, and these associations were robust after controlling for confounding,” wrote Daniel Corsi, Ph.D., of the University of Ottawa and colleagues.Corsi and colleagues analyzed the health outcomes of over 500,000 children born in Ontario between April 1, 2007, and March 31, 2012, by linking pregnancy data from Ontario ’s bi...
Source: Psychiatr News - Category: Psychiatry Tags: ADHD attention-deficit/hyperactivity disorder autism spectrum disorder cannabis Daniel Corsi developmental risks substance use Source Type: research
Diabetes complicating pregnancy not only has serious effects on mothers, but also may affect the function of multiple systems in the fetus, especially the development of nervous system[1-3], which is attracting more and more attention and research. Results from studies showed this participates in the development of autism spectrum disorders (ASD)[4, 5], attention-deficit/hyperactivity disorder (ADHD)[6, 7], low verbal IQ[8, 9], poorer general cognitive function[10, 11], and language impariment[12].
Source: Diabetes Research and Clinical Practice - Category: Endocrinology Authors: Tags: Review Source Type: research
Taking choline supplements during pregnancy may reduce the negative impact of viral respiratory infections on offspring, according to astudy published in theJournal of Psychiatric Research.“The new analysis may provide information relevant to potential COVID-19 effects on fetal brain development and their interaction with higher prenatal maternal choline levels,” wrote Robert Freedman, M.D., of the University of Colorado School of Medicine and colleagues.Previous studies showed that infection in pregnant women can affect fetal brain development and may increase the risk of attention-deficit/hyperactivity disord...
Source: Psychiatr News - Category: Psychiatry Tags: ADHD autism choline COVID-19 infant behavior Infant Behavior Questionnaire-Revised infections Journal of Psychiatric Research prenatal supplements Robert Freedman schizophrenia Source Type: research
Authors: Andrade C Abstract In observational studies, significant associations have often been identified between antidepressant drug prescription during pregnancy, on the one hand, and autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), on the other. Interpreting these associations is problematic because they are based on analyses that could not adjust for inadequately measured, unmeasured, and unknown confounds. Recent clinical data suggest that a genetic relationship exists between depression and neurodevelopmental disorders. A very recent study identified many genetic loci that w...
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
CONCLUSIONS: Reported associations between in utero exposure to antidepressants and physical, neurodevelopmental, and psychiatric outcomes, in large part, seem to be driven by the underlying maternal disorder. When limiting confounding by indication, prenatal exposure to antidepressants was significantly associated only with offspring BMI and affective disorders. PMID: 32412703 [PubMed - as supplied by publisher]
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
Authors: Andrade C Abstract Many observational studies have found an association between antidepressant drug prescription during pregnancy and neurodevelopmental disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder, and intellectual disability. The results of such studies cannot be considered conclusive because of the possible presence of inadequately measured, unmeasured, and unknown confounds. In this context, maternal anemia before or at but not after 30 weeks of gestation was recently associated with an increased risk of all 3 of these neurodevelopmental disorders. Additionally, ...
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
Abstract Preeclampsia is a dangerous hypertensive disorder of pregnancy with known links to negative child health outcomes. Here, we review epidemiological and basic neuroscience work from the past several decades linking prenatal preeclampsia to altered neurodevelopment. This work demonstrates increased rates of neuropsychiatric disorders [e.g., increased autism spectrum disorder, attention deficit hyperactivity disorder (ADHD)] in children of preeclamptic pregnancies, as well as increased rates of cognitive impairments [e.g., decreased intelligence quotient (IQ), academic performance] and neurological disease (e...
Source: Trends in Neurosciences - Category: Neuroscience Authors: Tags: Trends Neurosci Source Type: research
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