Effects of aspirin and acetaminophen in pregnancy and in the newborn

Abstract

Inhibitors of prostaglandin synthesis are increasingly recommended for delaying premature delivery. However, such inhibitors--eg, aspirin, indomethacin, or naproxen--may interfere with uterine contractility, with maternal, fetal, and neonatal platelet function, and especially with fetal circulation and postnatal adaptation. The instillation of aspirin (50 to 90 mg/kg of fetal body weight) into the rumina of fetal lambs resulted in significant increase of pulmonary arterial pressure, which was directly related to constriction of the ductus arteriosus. Such pressure elevation may act as a stimulus to increased muscular development in the small vessels of the lung, which, in turn, could interfere with the rapid reduction in pulmonary vascular resistance normally occurring after birth. The effects of acetaminophen in pregnancy and in the newborn have not been studied extensively; when ingested in usual therapeutic doses, the available data have shown no adverse effects.

Maternal use of acetaminophen and nonsteroidal anti‐inflammatory drugs (NSAIDs), and muscular ventricular septal defects

“…The majority of nonsyndromic mVSDs are thought to occur as a result of a complex interaction between environmental exposures and genetic susceptibilities. Few etiologic factors have been identified, including family history (Boughman et al, 1987), maternal fever during pregnancy (Buitendijk and Bracken, 1991; Botto et al, 2001, 2002;), and maternal medications including gastrointestinal medications, antitussives, and acetaminophen (Rudolph, 1981; Zierler and Rothman, 1985; Ferencz et al, 1997).…”

A critical review of the literature to conduct a toxicity assessment for oral exposure to methyl salicylate

“…Due to lack of appropriate protocol and dose response information presented in CIR (2003) the study was not considered for this assessment. Rudolph (1981) 4 This is a review article and not a toxicity study. 4 This is a review article and not a toxicity study.…”

“…The inhibition of COX-2 leads to the therapeutic effects associated with the use of salicylates as antipyretic, analgesic, and anti-inflammatory agents, and it can also lead to unwanted side effects due to decreased prostaglandin formation (Roberts & Morrow 2001). Prostaglandins play an important role in reproductive functions (Rudolph 1981). The inhibition of prostaglandins may interfere with uterine contractility, platelet function, and fetal vascular structure (Rudolph 1981).…”

“…Prostaglandins play an important role in reproductive functions (Rudolph 1981). The inhibition of prostaglandins may interfere with uterine contractility, platelet function, and fetal vascular structure (Rudolph 1981). Offspring of women that ingested salicylates for long periods during pregnancy have been reported to have significantly reduced body weights (Roberts & Morrow 2001).…”

Gynecologic malignancy in pregnancy

“…Antenatal repeated exposure to beta/dexamethasone resulted in hormonal disturbances, delay in maturation, and reduced brain and body burden in animal models [43]. Nonsteroidal anti-inflammatory drugs (NSAID) and acetaminophen are safe [44,45]. However, oligohydramnios, premature closure of the ductus arteriosus, and prolonged gestation are correlated with the effect of prostaglandins [46].…”