Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed drugs during pregnancy. Specifically, aspirin is given to mothers with high-risk pregnancies and produces a moderate reduction of certain risks, without infant bleeding, including preeclampsia, delivery before 37 weeks of gestation and fetal growth restriction. NSAIDs cross the placenta and the long-term effects on children are unknown. NSAIDs involve cyclooxygenase (COX)-1 and COX-2 inhibition. COX-2 has been shown to play a role in fetal brain development, specifically the dendritic branching involved in the developing areas of the brain that are responsible for cognitive function. The influence of NSAIDs on CNS development is not well understood and furthermore, their potential role in autism has not been studied.
The objective of the study is to identify a possible novel risk or protective factor, gestational exposure to NSAIDs associated with autism.
Northern California families were enrolled from 2003 to 2010 in the CHARGE (Childhood Autism Risks for Genetics and Environment) population-based case-control study. Children aged 24-60 months were evaluated and confirmed to have autism (n=357), autism spectrum disorder (ASD, n=163), or typical development (n=371) at the University of California-Davis Medical Investigation of Neurodevelopmental Disorders Institute using standardized clinical assessments (ADOS, ADI-R, Mullen’s Scales of Early Learning, and Vineland Adaptive Behavior Scales). The ASD group were those children who met criteria for autism on ADOS and on one of the communication or social domains on the ADI-R, and who were within 2 points of meeting the other cut-off. In our preliminary analysis, we calculated unadjusted odds ratios (ORs) for the association between autism and gestational exposure to NSAIDs (before and during pregnancy).
Mothers of children with autism were less likely than those of typically developing children to report having taken NSAIDs during periconception or pregnancy (OR=0.65, 95% CI 0.49-0.88). Moreover, mothers of children with autism and ASD combined were also less likely than those of typically developing children to report having taken NSAIDs during periconception and pregnancy (OR=0.67, 95% CI 0.51-0.88).
Our preliminary results may suggest protective relationship between gestational exposure to NSAIDs and autism, but further analysis is underway to address potential confounding or other bias. Nevertheless, this is a large study sample, the exposure is quite common, and relevant biologic pathways deserve further attention, as this relationship may be complex and needs to be further elucidated. If confirmed upon more rigorous analysis, this research may present possible novel inventions for the prevention of ASD and autism.
See more of: Epidemiology
See more of: Prevalence, Risk factors & Intervention