Effects of Acetylsalicylic Acid Ingestion on Maternal and Neonatal Hemostasis

Abstract

In a case-control study, we evaluated the effects of maternal ingestion of acetylsalicylic acid (aspirin) within 10 days of delivery on maternal and neonatal hemostasis. Only one of 34 control maternal-neonatal pairs (3 per cent) had hemostatic abnormalities. In 10 pairs, when maternal aspirin ingestion occurred within five days of delivery, 6 of 10 mothers and 9 of the 10 infants had bleeding tendencies. Seven maternal-neonatal pairs in which aspirin was ingested 6 to 10 days before delivery were free of clinical bleeding. Among seven other mothers who ingested aspirin in the immediate post-partum period four of the seven (57 per cent) also had impaired hemostasis. Neonatal hemostatic abnormalities included numerous petechiae over the presenting part, hematuria, a cephalhematoma, subconjunctival hemorrhage, and bleeding from a circumcision. Maternal bleeding was confined to excessive intrapartum or post-partum blood loss. We conclude that aspirin should be avoided during pregnancy. If ingestion has occurred within five days of delivery, the neonate should be evaluated for the presence of bleeding.

Platelet Function Tests in Childhood. Measuring Aggregation and Release Reaction in Whole Blood

“…Indeed, arachidonic acid was released in newborns as it was in adults, above all by thrombin. 3,22,23 The production of malonyldialdehyde in newborns was only slightly diminished in comparison with adults, 1524 as was the production of thromboxane B 2 . 3,11,25 The aggregation by serotonin was found to be decreased in newborns, 10,26,27 although the serotonin uptake was quite normal.…”

Developmental Hemostasis: Relevance to Hemostatic Problems During Childhood

“…75,79 The capacity of cord platelets to aggregate following exposure to a variety of agonists, including ADP, epinephrine, col lagen, thrombin, and arachidonic acid, has been variable, with some observations more consistent than others. [80][81][82][83] Cord platelet aggregation in response to epinephrine is markedly impaired due to decreased numbers of alphaadrenergic receptors. 81,84,85 This may be due to delayed maturation of these receptors or to occupation by cate cholamines that are released during the birth process.…”

“…79 Inositol phosphate production and protein phos phorylation are normal, as well as production of arachi donic acid and its metabolites. 82 In fact, cord platelets release more arachidonic acid than adult platelets in re sponse to stimulation by thrombin. 89 The latter may be due to platelet membranes made more reactive by low levels of vitamin E. 90 Agonist receptors, with the excep tion of the alpha-adrenergic receptor discussed pre viously, do not appear to be decreased in number.…”

Effects of Drugs and Chemicals on the Fetus and Newborn (First of Two Parts)

“…Bleyer and Breckenridge 94 compiled single cases of neonatal petechiae, purpura, and cephalohematoma after maternal ingestion of salicylate. Stuart and co-workers 95 validated a positive or negative history of maternal ingestion of aspirin by the in vitro evaluation of platelet malondialdehyde formation. When pregnant mothers had ingested aspirin within 5 days before delivery, 6 of 10 mothers and 9 of 10 infants had bleeding tendencies.…”