Aspirin During Pregnancy?

[dd99]

Is aspirin safe to take during pregnancy? (Just occasionally as a pain killer, not every day.)

 

[tara]

Good question. I was warned off it by dr, but I don't know if the evidence is strong one way or the other.

 

[Anonymous]

Yea aspirin breaks down to salicylic acid and salicylic acid is found in fruit. U should be fine, but I wouldn't go over 500 mg to be safe

 

[dd99]

Thanks for your comments. I spoke to Dr Peat about this (he was very helpful). Here is his reply.

Aspirin has a good record of safety in pregnancy, paracetamol doesn’t. It became the most commonly used analgesic, displacing aspirin, because of advertising, not science.

Aspirin has been studied mainly in women with a tendency to miscarry or to develop preeclampsia, and it improved the health of their babies, but I don’t know of any good animal studies that would involve a realistic intermittent use of larger doses.


PLoS One. 2014 Sep 24;9(9):e108210.
Associations between acetaminophen use during pregnancy and ADHD symptoms
measured at ages 7 and 11 years.
Thompson JM(1), Waldie KE(2), Wall CR(3), Murphy R(4), Mitchell EA(1); ABC study
group.
Collaborators: Robinson E, Becroft D, Wild C.
(1)Department of Paediatrics, The University of Auckland, Auckland, New Zealand.
(2)School of Psychology, The University of Auckland, Auckland, New Zealand.
(3)Discipline of Nutrition, The University of Auckland, Auckland, New Zealand.
(4)Department of Medicine, The University of Auckland, Auckland New Zealand.
OBJECTIVE: Our aim was to replicate and extend the recently found association
between acetaminophen use during pregnancy and ADHD symptoms in school-age
children.
METHODS: Participants were members of the Auckland Birthweight Collaborative
Study, a longitudinal study of 871 infants of European descent sampled
disproportionately for small for gestational age. Drug use during pregnancy
(acetaminophen, aspirin, antacids, and antibiotics) were analysed in relation to
behavioural difficulties and ADHD symptoms measured by parent report at age 7 and
both parent- and child-report at 11 years of age. The analyses included multiple
covariates including birthweight, socioeconomic status and antenatal maternal
perceived stress.
RESULTS: Acetaminophen was used by 49.8% of the study mothers during pregnancy.
We found significantly higher total difficulty scores (Strengths and Difficulty
Questionnaire parent report at age 7 and child report at age 11) if acetaminophen
was used during pregnancy, but there were no significant differences associated
with any of the other drugs. Children of mothers who used acetaminophen during
pregnancy were also at increased risk of ADHD at 7 and 11 years of age (Conners'
Parent Rating Scale-Revised).
CONCLUSIONS: These findings strengthen the contention that acetaminophen exposure
in pregnancy increases the risk of ADHD-like behaviours. Our study also supports
earlier claims that findings are specific to acetaminophen.

J Endod. 2015 May;41(5):588-593.
Acetaminophen: Old Drug, New Issues.
Aminoshariae A(1), Khan A(2).
(1)Department of Endodontics, Case School of Dental Medicine, Cleveland, Ohio.
Electronic address: [email protected]. (2)Department of Endodontics, University of
North Carolina, Chapel Hill, North Carolina.
INTRODUCTION: The purpose of this review was to discuss new issues related to
safety, labeling, dosing, and a better understanding of the analgesic effect of
acetaminophen.
METHODS: The MEDLINE, Embase, Cochrane, and PubMed databases were searched.
Additionally, the bibliography of all relevant articles and textbooks were
manually searched. Two reviewers independently selected the relevant articles.
RESULTS: Concerns about acetaminophen overdose and related liver failure have led
the US Food and Drug Administration to mandate new labeling on acetaminophen
packaging. In addition, large-scale epidemiologic studies increasingly report
evidence for second-generation adverse effects of acetaminophen. Prenatal
exposure to acetaminophen is associated with neurodevelopmental and behavioral
disorders. Recent studies also suggest that acetaminophen is a hormone disrupter
(ie, it interferes with sex and thyroid hormone function essential for normal
brain development) and thus may not be considered a safe drug during pregnancy.
Finally, emerging evidence suggests that although the predominant mechanism by
which acetaminophen exerts its therapeutic effect is by inhibition of
cyclooxygenase, multiple other mechanisms also contribute to its analgesic
effect.
CONCLUSIONS: Available evidence suggests that indiscriminate usage of this drug
is not warranted. and its administration to a pregnant patient should be
considered with great caution.
Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc.
All rights reserved.

J Hepatol. 2015 May;62(5):1085-91.
Prenatal acetaminophen induces liver toxicity in dams, reduces fetal liver stem
cells, and increases airway inflammation in adult offspring.
Karimi K(1), Keßler T(2), Thiele K(3), Ramisch K(3), Erhardt A(2), Huebener P(4),
Barikbin R(2), Arck P(3), Tiegs G(5).
(1)Institute of Experimental Immunology and Hepatology, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany. Electronic address: [email protected].
(2)Institute of Experimental Immunology and Hepatology, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany. (3)Laboratory for Experimental Feto-Maternal
Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany. (4)I. Medical Clinic, University Medical
Center Hamburg-Eppendorf, Hamburg, Germany. (5)Institute of Experimental
Immunology and Hepatology, University Medical Center Hamburg-Eppendorf, Hamburg,
Germany. Electronic address: [email protected].
BACKGROUND & AIMS: During pregnancy, acetaminophen is one of the very few
medications recommended by physicians to treat fever or pain. Recent insights
from epidemiological studies suggest an association between prenatal
acetaminophen medication and an increased risk for development of asthma in
children later in life. The underlying pathogenesis of such association is still
unknown.
METHODS: We aimed to develop a mouse model to provide insights into the effect of
prenatal acetaminophen on maternal, fetal and adult offspring's health. The toxic
effect of acetaminophen was studied in mice on 1) maternal liver; mirrored by
biomarkers of liver injury, centrilobular necrosis, and infiltration of
granulocytes; 2) fetal liver; reflected by the frequency of hematopoietic stem
cells, and 3) postnatal health; evaluated by the severity of allergic airway
inflammation among offspring.
RESULTS: We observed an increased susceptibility towards acetaminophen-induced
liver damage in pregnant mice compared to virgins. Moreover, hematopoietic stem
cell frequency in fetal liver declined in response to acetaminophen. Furthermore,
a greater severity of airway inflammation was observed in offspring of dams upon
prenatal acetaminophen treatment, identified lung infiltration by leukocytes and
eosinophil infiltration into the airways.
CONCLUSION: Our newly developed mouse model on prenatal use of acetaminophen
reflects findings from epidemiological studies in humans. The availability of
this model will allow improvement in our understanding of how
acetaminophen-related hepatotoxicity is operational in pregnant individuals and
how an increased risk for allergic diseases in response to prenatal acetaminophen
is mediated. Such insights, once available, may change the recommendations for
prenatal acetaminophen use.
Copyright © 2014 European Association for the Study of the Liver. All rights
reserved.

J Allergy Clin Immunol. 2015 Feb;135(2):449-50.
Acetaminophen and childhood asthma: pill-popping at our peril?
Shaheen SO(1).
(1)Centre for Primary Care and Public Health, Barts and The London School of
Medicine and Dentistry, Queen Mary University of London (QMUL), London, United
Kingdom. Electronic address: [email protected].
Comment on
J Allergy Clin Immunol. 2015 Feb;135(2):441-8.

Expert Rev Clin Pharmacol. 2014 Sep;7(5):655-62. doi:
10.1586/17512433.2014.944502. Epub 2014 Jul 30.
New problems arising from old drugs: second-generation effects of acetaminophen.
Tiegs G(1), Karimi K, Brune K, Arck P.
(1)Institute of Experimental Immunology and Hepatology, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany.
Acetaminophen (APAP)/paracetamol is one of the most commonly used
over-the-counter drugs taken worldwide for treatment of pain and fever. Although
considered as safe when taken in recommended doses not higher than 4 g/day, APAP
overdose is currently the most important cause of acute liver failure (ALF). ALF
may require liver transplantation and can be fatal. The reasons for APAP-related
ALF are mostly intentional (suicidal) or unintentional overdose. However, results
from large scale epidemiological studies provide increasing evidence for second
generation effects of APAP, even when taken in pharmacological doses. Most
strikingly, APAP medication during pregnancy has been associated with health
problems including neurodevelopmental and behavioral disorders such as attention
deficit hyperactivity disorder and increase in the risk of wheezing and incidence
of asthma among offspring. This article reviews the epidemiological findings and
aims to shed light into the molecular and cellular mechanisms responsible for
APAP-mediated prenatal risk for asthma.

Can Fam Physician. 2014 Jul;60(7):642.
Acetaminophen in pregnancy and future risk of ADHD in offspring.
Blaser JA(1), Allan GM(2).
(1)Assistant Professor in the Department of Academic Family Medicine at the
University of Saskatchewan in Saskatoon. (2)Professor in the Department of Family
Medicine at the University of Alberta in Edmonton.

Lakartidningen. 2014 Aug 20-Sep 2;111(34-35):1350, 1352.
[Paracetamol for children and pregnant--the precautionary principle should
prevail. Be cautious with paracetamol while the risk for ADHD and asthma is being
investigated].
[Article in Swedish]
Axelsson I.

Acta Obstet Gynecol Scand. 2015 May 4.
Changes in the pattern of paracetamol use in the periconception period in a
Danish cohort.
Ersbøll AS(1), Hedegaard M, Damm P, Johansen M, Tabor A, Hegaard HK.
(1)Research Unit,Women's and Children's Health, Rigshospitalet Copenhagen
University Hospital, Copenhagen; Department of Obstetrics, Rigshospitalet
Copenhagen University Hospital, Copenhagen.
Paracetamol is the most commonly used over-the-counter drug in pregnancy. It is
generally considered to be safe, but prolonged antenatal exposure has been
associated with offspring short- and long-term morbidity. Our aim was to describe
the pattern of paracetamol use with a focus on frequent ingestion (>1 time/week),
three months before and in early pregnancy. In this cohort, 8650 pregnant women
responded to a web-based clinical questionnaire that included questions about
drug use. Paracetamol was the most used drug before and in early pregnancy (35.2%
and 6.5% of respondents, respectively). The proportion of frequent users
decreased from 3.9% before to 0.9% in early pregnancy. Frequent paracetamol use
was associated with smoking, co-morbidities, body mass index ≥25 kg/m(2) ,
unplanned pregnancy, no education, and inability to understand Danish. A
significant decrease in the proportion of women with any paracetamol use in early
pregnancy was noted after access to large packs was restricted by legislation.
This article is protected by copyright. All rights reserved.

Dev Med Child Neurol. 2015 Apr 7.
Use of paracetamol during pregnancy and child neurological development.
de Fays L(1), Van Malderen K, De Smet K, Sawchik J, Verlinden V, Hamdani J, Dogné
JM, Dan B.
(1)Federal Agency for Medicines and Health Products (FAMHP), Brussels, Belgium.
Paracetamol (acetaminophen) remains the first line for the treatment of pain and
fever in pregnancy. Recently published epidemiological studies suggested a
possible association between paracetamol exposure in utero and
attention-deficit-hyperactivity disorder/hyperkinetic disorder (ADHD/HKD) or
adverse development issues in children. However, the effects observed are in the
weak to moderate range, and limitations in the studies' design prevent inference
on a causal association with ADHD/HKD or child neurological development. In
parallel, recent animal data showed that cognition and behaviour may be altered
following exposure to therapeutic doses of paracetamol during early development.
These effects may be mediated by interference of paracetamol with brain-derived
neurotrophic factor, neurotransmitter systems (including serotonergic,
dopaminergic, adrenergic, as well as the endogenous endocannabinoid systems), or
cyclooxygenase-2. However, no firm conclusion can be made on the relevance of
these observations to humans. We conclude that additional well-designed cohort
studies are necessary to confirm or disprove the association. In the context of
current knowledge, paracetamol is still to be considered safe in pregnancy and
should remain the first-line treatment for pain and fever.

 

[Rosi]

Hi, I'm 5 week pregnant and during pregnancy I have taken around 12 pills 500mg aspirin. I didnt know that is too high dose for pregnancy. I'm really scarry what to do.