Recently, Robert F. Kennedy Jr. made headlines in the United States when he claimed that Tylenol use during pregnancy causes autism and should be avoided. While there is no scientific evidence to support this claim, there are legitimate concerns about another over-the-counter drug: aspirin. Some studies have found that the use of aspirin and other non-steroidal anti-inflammatory drugs like ibuprofen and acetaminophen may slightly increase the risk of an infant developing cerebral palsy (CP).
These studies are limited and do not establish a definitive causal connection between aspirin use and cerebral palsy. However, it does raise some questions about the use of these common painkillers during pregnancy. While these medications may be necessary if you are dealing with certain health issues, such as a fever, you should always consult with your doctor before taking any medication when you are pregnant.
At the Birth Injury Lawyers Alliance (BILA), we advocate for children and families whose lives have been affected by birth injuries. We work tirelessly to help families discover what led to their child’s diagnosis, whether it be medical negligence or another cause. If you believe that your child developed CP because of medical negligence, reach out today to schedule a free initial consultation with a birth injury lawyer in your province.
What Causes Cerebral Palsy?
Cerebral palsy is a group of conditions that affect movement and posture. It is caused by damage to the developing brain. In most cases, this damage occurs during pregnancy, prior to birth.
In many cases, the exact cause of CP is not known. However, scientists have isolated some factors that can impact brain development in a fetus. This includes:
- Gene changes that cause differences in brain development
- Maternal infections that can impact a fetus, including cytomegalovirus, rubella, herpes, syphilis, toxoplasmosis, intrauterine infections, exposure to toxins, and Zika virus
- Strokes that can interrupt the blood supply to the fetus
- Bleeding into the brain, either before or after birth
- Infant infections that can cause swelling in or around the brain
- Lack of oxygen to the brain during labour and delivery
- Traumatic head injury to an infant
These and other issues can cause one of 5 types of cerebral palsy:
- Spastic
- Ataxic
- Athetoid (dyskinetic)
- Hypotonic
- Mixed cerebral palsy
In many cases, the development of cerebral palsy could have been avoided with proper medical care. If you believe that your child’s CP was caused by medical negligence, you may have a potential birth injury lawsuit claim.
Can Aspirin Use During Pregnancy Cause Cerebral Palsy?
In 2018, researchers from the University of Copenhagen in Denmark conducted a study to determine if the use of aspirin and acetaminophen during pregnancy could be linked to the potential development of CP in children. These scientists studied nearly 190,000 mother-child pairs as part of this study and found that women who took aspirin during pregnancy were more than twice as likely to deliver children with bilateral spastic cerebral palsy.
To reach this conclusion, the researchers reviewed the medical records of the mothers, dividing them into categories based on whether or not they had used aspirin or acetaminophen during pregnancy. Of the mothers in the study:
- 49% used acetaminophen at least once during pregnancy
- 3% used aspirin at least once during pregnancy
- 4% used ibuprofen at least once during pregnancy
Among the mothers who used an over-the-counter NSAID during pregnancy, 357 of their babies were diagnosed with cerebral palsy. Using statistical models, the team determined that children who were exposed to aspirin during pregnancy were 2.4 times more likely to develop bilateral spastic cerebral palsy compared to children whose mothers had not taken the medication. Similarly, the use of acetaminophen was associated with a 30 to 60% increase in cerebral palsy diagnoses compared to children who were not exposed to the medication.
This study is both interesting and important, but it is important to recognize its limitations. The study did not establish a cause-and-effect relationship between the use of aspirin or acetaminophen during pregnancy and the development of CP. It is also possible that the children of the mothers who had taken these medications had other underlying conditions.
For example, conditions like preeclampsia and certain maternal infections are directly associated with the development of cerebral palsy. A mother with one of these conditions might take an over-the-counter medication to lower her blood pressure or treat the symptoms. Those conditions might be both the reason why a fetus was exposed to aspirin and why it developed cerebral palsy.
A more recent study published in the Journal of Pediatrics found that there is no link between prenatal exposure to paracetamol (acetaminophen) in early pregnancy and the development of cerebral palsy. This study examined 923 cerebral palsy cases in Sweden from 1995 to 2014, where the mother had given a serum sample during early pregnancy. Overall, the researchers found that mothers who took this medication during pregnancy did not have a higher risk of delivering a baby with CP compared to mothers who did not take acetaminophen.
Ultimately, we do not yet know if there is a direct link between the use of aspirin or acetaminophen during pregnancy and cerebral palsy. As with all medications, if you are an expectant mother, you should be careful when taking these drugs. Even over-the-counter medications can potentially impact a developing brain, so always check with your doctor before taking aspirin or another medicine when pregnant.
Is It Safe to Take Aspirin While Pregnant?
According to the American College of Obstetricians & Gynecologists (ACOG), it is generally safe to take low-dose aspirin throughout pregnancy. A low dose of aspirin is 81 milligrams. However, higher doses of aspirin should be avoided during pregnancy.
Low-dose aspirin may be recommended by your doctor in certain situations. For example, if you have preeclampsia or are at risk for developing this condition, your obstetrician may recommend that you take low-dose aspirin to manage the condition. This is typically considered safe for both the mother and baby. Managing prenatal high blood pressure can actually reduce the risk of a baby developing a condition like cerebral palsy.
While low-dose aspirin is generally safe, you should not take a larger dose (above 81 mg) during pregnancy. Higher doses of aspirin are associated with risks based on the stage of pregnancy:
- During the first trimester, taking higher doses of aspirin is associated with a higher risk of pregnancy loss and congenital defects.
- During the second trimester, taking higher doses of aspirin or other over-the-counter NSAIDS (including ibuprofen or naproxen sodium) is not recommended. After 19 weeks of pregnancy, taking these medications increases the risk of serious kidney conditions that could lead to low levels of amniotic fluid.
- During the third trimester, taking higher doses of aspirin increases the risk that a vessel in the fetus’s heart will close too soon.
Using high-dose aspirin for long periods of time at any stage of pregnancy also increases the risk of bleeding in the brain of premature infants. It can also negatively affect fetal growth and increase the likelihood of placental abruption.
It may be necessary to take a pain reliever while you are pregnant. If you find yourself in that situation, talk to your healthcare provider about what options are best. They will likely recommend something other than aspirin (such as acetaminophen) to reduce the likelihood of potential complications for both mother and baby.
Generally, taking acetaminophen during pregnancy is considered safe, particularly in the second and third trimesters. While there have been allegations about prenatal acetaminophen use and ADHD and autism, there has never been a conclusive study that links this medication with these conditions or cerebral palsy. Overall, acetaminophen is considered one of the safest medications that a woman can take while she is pregnant.
Of course, even acetaminophen may have risks when you are pregnant. It is still a drug and should be treated as such. You should always talk to your doctor about any medication that you take during pregnancy. You can also ask them for alternatives if you are concerned about using aspirin, acetaminophen, or any other medication while you are expecting.
Help from a Seasoned Birth Injury Lawyer
While there has been some research that suggests a link between aspirin use during pregnancy and cerebral palsy, no conclusive connection has been established. However, the use of high-dose aspirin during pregnancy is considered risky and should be avoided. Ultimately, you should always consult with a physician before you take medication when you are pregnant.
At the Birth Injury Lawyers Alliance, we advocate for families whose children have been diagnosed with a birth injury due to medical negligence during pregnancy, labour and delivery, and in the first weeks and months after birth. For assistance with cerebral palsy and other birth injury claims, call BILA today at 1-800-300-BILA or fill out our online contact form to schedule a free initial consultation with a lawyer in your province.
The Birth Injury Lawyers’ Alliance of Canada (BILA) was formed in 2016 by a group of lawyers from across Canada with considerable experience in birth injury cases to promote the effective representation of children and families affected by avoidable injuries occurring at or around the time of birth.
