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In Utero Exposure to Aspirin and Risk of Asthma in Childhood

Chu, Shuyuan; Huang, Lisu; Bao, Yixiao; Bao, Jun; Yu, Hongping; Zhang, Jun

doi: 10.1097/EDE.0000000000000519

Background: Aspirin is widely used in general population and low-dose aspirin is commonly prescribed to prevent recurrent pregnancy loss associated with antiphospholipid syndrome and preeclampsia, often used throughout pregnancy. But aspirin is associated with asthma pathogenesis. We aim to examine whether in utero exposure to aspirin at different fetal stages is associated with asthma in childhood.

Methods: We used data from the Collaborative Perinatal Project. Maternal exposure to aspirin before and during pregnancy was recorded at each prenatal visit. Children were followed up to 7 years of age. A total of 19,928 singleton children without maternal history of asthma were included. We used multilevel multiple logistic regression models to control for potential confounders.

Results: In utero exposure to aspirin was associated with an increased risk of childhood asthma (adjusted odds ratio [aORs] = 1.3, 95% confidence interval [CI] = 1.1, 1.6). aORs for exposure in first, second, and third trimesters were 1.1 (95% CI = 0.87, 1.3), 1.2 (95% CI = 1.0, 1.4), and 1.4 (95% CI = 1.1, 1.6), respectively. Furthermore, aORs of asthma were 1.3 (95% CI = 1.0, 1.7) and 1.3 (95% CI = 1.0, 1.7) for aspirin use for 2 to 7 days or more than 7 days in third trimester, respectively.

Conclusion: In utero exposure to therapeutic dose of aspirin even just briefly in late pregnancy is associated with childhood asthma by 7 years of age. More research is needed to carefully examine the association between low-dose aspirin with extended exposure period and long-term child outcomes.

From the aMOE-Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; bDepartment of Respiratory Medicine, the Affiliated Hospital of Guilin Medical University, Guilin, China; cDepartment of Pediatrics, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; and dSchool of Public Health, Guilin Medical University, Guilin, China.

Submitted 17 July 2015; accepted 27 May 2016.

Supported in part by grants from the National Natural Science Foundation of China (81530086), the Ministry of Education of the People’s Republic of China (20130073110012), the Ministry of Science and Technology of China (2014DFG31460), Shanghai Municipal Public Health Bureau (AB83070002012016), and Shanghai Municipal Science and Technology Commission (14XD1403300).

The authors report no conflicts of interest.

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Correspondence: Jun Zhang, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.;and Hongping Yu, School of Public Health, Guilin Medical University, Guilin, 541004, China. E-mail:

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.