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Oral Concurrent Session 6 - Medical Complications
Oral Concurrent Sessions
Expedited Sessions
Guidelines recommend prescribing low-dose aspirin (LDA) to at-risk pregnant women for the prevention of preeclampsia; however, the impact of antenatal LDA on neurodevelopment is limited. We therefore sought to determine if there were differences in neurodevelopment in children whose mothers had been antenatally randomized to LDA or a placebo.
Study Design: We performed a non-inferiority masked neurodevelopmental follow-up study of a randomly selected subset of children between 33 and 39 months of age in five Low-Middle Income Countries whose mothers had participated in a randomized trial of daily LDA (81mg) or an identical placebo, initiated between 6 weeks and 0 days and 13 weeks and 6 days of pregnancy. LDA was continued to 36 weeks of gestation or birth if it occurred earlier. Children were excluded if they had a significant congenital anomaly that would preclude testing. Children were evaluated using the Bayley Scale of Infant Development-III (BSID-III) and the Ages and Stages Questionnaire 3rd Edition (ASQ-3). Our primary outcome was the cognitive composite score of the BSID-III with the threshold of non-inferiority being defined as a > 4-point difference.
Results: A total of 644 children (330 LDA and 314 placebo) were evaluated. Maternal and delivery characteristics did not differ between the two groups (table 1). The cognitive composite score of the BSID-III was non-inferior and did not differ between the two groups (LDA 96+ 10 SD vs. Placebo 97+ 10, p=0.25). No differences were seen in the BSID-III language composite score (LDA 101+ 13 SD vs. Placebo 100+ 14, p=0.38) or BSID-III the motor composite score (LDA 99+ 13 SD vs. Placebo 100+ 14, p=0.50). No differences in the communication, gross motor, fine motor, problem solving and personal-social components of the ASQ-3 were detected. Breastfeeding rates, breastfeeding duration, maternal education, and home environment as measured by the Family Care Indicators did not differ between the two groups.
Conclusion:
Antenatal LDA exposure beginning as early 6 weeks gestation is not associated with neurodevelopmental delay at 33 to 39 months of age.
Matthew Hoffman, MD mph
Marie E. Pinizzotto, M.D., Endowed Chair of Obstetrics and Gynecology at Christiana Care
Department of Obstetrics and Gynecology, Christiana Care Health System
Newark, Delaware, United States
Sangappa Dhaded, MD
Jawaharlal Nehru Medical College, KLE University
Belgaum, Karnataka, India
Lester Figueroa, MD
INCAP - Instituto de Nutrición de Centro América y Panamá
Guatemala City, Quetzaltenango, Guatemala
Manolo Mazariegos, MD
INCAP - Instituto de Nutrición de Centro América y Panamá
Guatemala City, Solola, Guatemala
Nancy F. Krebs, MD
University of Colorado, Anschutz Medical Campus
Aurora, CO, United States
Shiyam Sunder, MD
Aga Khan University
Aga Khan University, Islamabad, Pakistan
Fatima Karim, MD
Aga Khan University
Karachi, Sindh, Pakistan
Adrien Lokangaka, MD, MPH
University of Kinshasha
University of Kinshasha, Kinshasa, Congo, (Congo – Kinshasa)
Melissa Buserman, MD
University of North Carolina Chapel Hill
University of North Carolina, NC, United States
Archana Patel, MD, PhD
Lata Medical Research Foundation
LATA Medical Research Foundation, Karnataka, India
Patricia Hibberd, MD, PhD
Boston University School of Public Health
Boston University School of Public Health/Boston, MA, United States
Prabir Das, MD, PhD
Lata Medical Research Foundation
LATA Medical Research Foundation, Maharashtra, India
Antoinette Tshefu, MD, PhD
Kinshasa School of Public Health
Kinshasa, Kinshasa, Congo, (Congo – Kinshasa)
Elwyn Chomba, MD
University of Zambia School of Medicine
Lusaka, Lusaka, Zambia
Musaku Mwencheanya, MD
University Teaching Hospital
University Teaching Hospital, Lusaka, Zambia
Waldemar Carlo, MD
Center for Women’s Reproductive Health and University of Alabama at Birmingham
Birmingham, Alabama, United States
Marissa Trotta, PhD
RTI International
RTI International/Research Triangle Park, NC, United States
Alexis Williams-Jones, BS
RTI International
RTI International/Research Triangle Park, NC, United States
Janet Moore, BS, MS
RTI International
Research Triangle Park, NC, United States
Tracy Nolen
RTI International
Research Triangle Park, NC, United States
Elizabeth M. McClure, PhD
Senior Research Epidemiologist
RTI International
Durham, North Carolina, United States
Michelle Lobo, PhD
University of Delaware
University of Delaware and Newark, DE, United States
Andrea Cunha, PhD
University of Delaware
University of Delaware and Newark, DE, United States
Richard Derman, MD, MPH
Thomas Jefferson University
Thomas Jefferson/University, PA, United States