Birth defects (such as amniotic band syndrome, cleft lip, cleft palate, spina bifida, anophthalmia, microphthalmia, and clubfoot) have all been linked to the maternal use of aspirin and other NSAID painkillers early in pregnancy.
Aspirin is a common painkiller, and is also prescribed to people to reduce their chance of having a heart attack if they are at high risk. Aspirin belongs to group of medications known as NSAIDs, or “Non-Steroidal Anti-Inflammatory Drugs.” You probably have one or more NSAIDs in your medicine cabinet — Aleve (naproxen), Advil (ibuprofen), Vioxx, Celebrex, Cataflam, Arthrotex, and Nabumetone all belong to this group of medications.
They are usually prescribed to treat mild to moderate pain, inflammation, fever, and arthritis, by inhibiting a certain enzyme that is involved in inflammation. Aspirin also reduces the risk that a person will develop blood clots, which can travel through the body and cause stroke, pulmonary embolism, heart attack, or death.
Aspirin and Pregnancy
In December 2011, new research emerged that found a link between the use of NSAIDs during pregnancy, including aspirin, and an increased chance of having a baby with one of the following serious birth defects:
- Amniotic band syndrome: This birth defect occurs when parts of the amniotic sac separate, form bands, and the developing baby becomes entangled. The severity of this birth defect varies widely, depending on what part of the baby is entangled, and how tightly the bands are wrapped. Sometimes children must have fingers or limbs amputated; sometimes the constriction can be life-threatening. Amniotic band syndrome is three times more likely in babies born to mothers who took an NSAID, such as aspirin, during the first trimester.
- Clubfoot: This condition occurs when there are problems in the way the baby’s foot and ankle develops, and is not caused by the positioning of the fetus in the womb. When a baby is born with clubfoot, the foot is turned at a sharp angle at the ankle, and points inward. Babies born with this condition may need corrective surgery. Recently, there have been advances in treatment that involves gradually lengthening the tendons and ligaments in the foot using bands and casts.
- Anophthalmia and Microphthalmia: When a baby has anophthalmia, he or she is born lacking eyes. When a baby is born with microphthalmia, he or she is born with much smaller eyes than normal. Both these conditions result in blindness, which is not correctable. When mothers took NSAIDs, including aspirin, this birth defect was three times more likely to occur.
- Cleft Lip and Cleft Palate: Both these birth defects result in facial deformities and problems feeding, which can result in impaired growth. Cleft lip occurs when the left and right side of the upper lip are separated, and may be a small notch or a wide separation that extends into the nose. Cleft palate affects the hard and/or soft palate (the roof of the mouth) and can impair eating, sucking, and swallowing. The risk of these birth defects increased between 30-80% in babies whose mothers took aspirin or NSAIDs early in pregnancy.
- Spina Bifida: This birth defect occurs during fetal development in the womb, and occurs when the neural tube that normally protects the spinal cord has an abnormal opening, which exposes the spinal cord to the amniotic fluid in the womb. Damage to the spinal cord can be mild to severe, but usually results in permanent, lifelong paralysis. The rate of spina bifida was 60% higher for babies born to mothers who took Aspirin or NSAIDs during pregnancy
Aspirin Birth Defect Study
In December 2011, researchers found a link between the maternal use of aspirin and other NSAIDs and the birth defects listed above. The researchers used information on more than 15,000 women who had babies with birth defects, and they compared this information to 5,500 mothers of children without birth defects.
The data came from the National Birth Defects Prevention Study, and the results were published in the American Journal of Obstetrics and Gynecology. The researchers found no link between most birth defects and NSAIDs, but did for some serious birth defects. Because the defects are relatively rare, even a three-fold increase in the rate translates to relatively few cases. Even so, they recommended that women refrain from using NSAIDs during pregnancy due to the slightly increased risk of having a baby with an aspirin birth defect.
What is Aspirin prescribed for?
Aspirin may be prescribed for the following conditions:
- Relief of pain, tenderness, swelling and stiffness caused by osteoarthritis
- Rheumatoid arthritis
- Juvenile arthritis
- Ankylosing spondylitis (arthritis of the spine)
- Shoulder pain
- Menstrual pain
- Reduce fever
- Mild headaches
- Muscle aches
Aspirin may also be prescribed to reduce the chance of heart attacks in people who are at high-risk of having a heart attack caused by blood clots, because aspirin is a blood-thinner.