140 - Exposure to Maternal Acetylsalicylic Acid and the Risk of Bleeding Events in Extreme Premature Neonates

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 140
Publication Number: 140.239

Gabriel Altit, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Justine Morin, McGill University Faculty of Medicine and Health Sciences, Mirabel, PQ, Canada; Joanne Delaney, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Gabriela De Carvalho Nunes, Dalhousie University Faculty of Medicine, Saint John, NB, Canada; Marc Beltempo, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Catherine Goudie, Montreal Children's Hospital, Montreal, PQ, Canada; Isabelle Malhamé, McGill University Health Centre, Montreal, PQ, Canada; Jessica Simoneau, McGill University Faculty of Medicine and Health Sciences, Vercheres, PQ, Canada

Presenting Author(s)

Gabriel Altit, MDCM, MSc, FRCPC, FAAP (he/him/his)

Assistant Professor - Neonatologist - Montreal Children's Hospital
McGill University Faculty of Medicine and Health Sciences
Montreal, Quebec, Canada

Background: Acetylsalicylic acid (ASA) is commonly prescribed for prophylaxis of maternal preeclampsia, a condition increasing the risk of delivering preterm. Preeclampsia is a serious hypertensive disorder affecting mothers and is associated with various neonatal complications. Previous studies have suggested an association between maternal ASA exposure and increased intraventricular hemorrhage [IVH] amongst term neonates. The incidence of IVH grade 3 or above is around 15% in the premature population and is associated with adverse neurodevelopmental outcomes. Limited data exists regarding the occurrence of significant bleeding events in extremely preterm infants and their association with maternal ASA.

Objective: To assess whether exposure to ASA during pregnancy is associated with bleeding events in extremely premature infants.

Design/Methods: Retrospective cohort of extremely premature neonates, born at < 29 weeks and admitted to a level 3 neonatal intensive care unit between 2015 and 2019. Information on ASA exposure and covariates were collected from the medical records. We considered a major bleeding event if there was the presence of an IVH grade ≥3 at any point during hospitalization or a significant pulmonary hemorrhage (requiring intubation or associated with a rise in oxygen and a confirmatory radiography). Descriptive and logistic regression analyses were used.

Results: 289 infants were included, of which 40 were exposed to maternal ASA. Rates of IVH (n=3 (8%) vs n=39 (16%) p=0.23), pulmonary hemorrhage (n=5 (13%) vs n=18 (7%), p=0.22) or significant bleeding events (n=7 (18%) vs n=49 (20%), p=0.83) were similar between groups. Adjusting for maternal hypertension and gestational age at birth, there was no association between maternal ASA exposure and major bleeding events (adjusted OR = 0.83, 95% Confidence Interval: 0.34-2.01).

Conclusion(s):

This study did not identify a major safety concern regarding significant bleeding events in the context of maternal exposure to in extremely premature neonates. Further studies, with larger cohorts, may be warranted to establish recommendations applicable to clinical practice and to corroborate our findings.