50 Years Ago in TheJournalofPediatrics: Neonatal Platelet Aggregation: Effects of Antenatal Aspirin

Abstract

Corby DG, Schulman I. The Effects of Antenatal Drug Administration on Aggregation of Platelets of Newborn Infants. Pediatr Pharmacol Ther 1971;79:307-13. Fifty years ago in The Journal, Corby and Schulman described the effect of antenatal drugs on neonatal platelet aggregation. They compared cord blood from term infants with maternal blood, after different antenatal drug intake. Aspirin was the most potent drug, leading to significantly impaired platelet aggregation in the neonates. The methodology for assessment of platelet aggregation was discovered in the 1950s, and the method used, light transmission aggregometry, is still the gold standard for aggregation testing.1Hechler B. Dupuis A. Mangin P.H. Gachet C. Platelet preparation for function testing in the laboratory and clinic: Historical and practical aspects.Res Pract Thromb Haemos. 2019; 3: 615-625Crossref PubMed Scopus (19) Google Scholar Antenatal drugs are well-known to have potential detrimental effects on the fetus, as it has been shown for aspirin; for most drugs the effects are dose dependent. Aspirin in small doses from less than 16 to 36 weeks of gestation significantly reduce preeclampsia, and is recommended by the World Health Organization.2Cui Y. Zhu B. Zheng F. Low-dose aspirin at ≤16 weeks of gestation for preventing preeclampsia and its maternal and neonatal adverse outcomes: a systematic review and meta-analysis.Exp Ther Med. 2018; 15: 4361-4369PubMed Google Scholar Studies like Corby and Schulman's contributed to the understanding of the effects of antenatal drug use, and were important in minimizing potential ill effects for the fetus during pregnancy. Although we now know that aggregation in cord blood does not reflect aggregation in peripheral blood, Corby and Schulman's result still have significance, because aspirin has been shown to have these effects also in peripheral blood, although of somewhat lesser severity.3Grevsen A.K. Hviid C.V.B. Hansen A.K. Hvas A.M. Platelet count and function in umbilical cord blood versus peripheral blood in term neonates.Platelets. 2020; 6: 1-7Google Scholar Fifty years after this publication, we have achieved a substantial leap forward in our understanding of antenatal drug use and potential effects on the fetal development and well-being, thanks to several studies and publications on the topic, like Corby and Schulman's study.