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Two reports from Australia describe maternal [1] and fetal [2] effects of regular aspirin ingestion during pregnancy. Their results suggest that the regular consumption of salicylates can have detrimental effects on the health of both mother and baby. To prevent such effects, it may be wise to combine counselling on the possible effects of salicylates and urinary salicylate screening of pregnant women in those countries where use of these agents is high.

The study's subjects were clinic patients, which, in Australia means the patients were from the lower socioeconomic groups. Users of salicylates were identified by urine tests (10% ferric chloride solution) performed during pregnancy. Of the 114 salicylate users, 63 (Group I) were 'constant takers', takit_lg analgesics every day during pregnancy, and 81 (Group II) were 'intermittent takers', taking analgesics at least once a week throughout pregnancy. The salicylate users represented 6.6% of Australian-born patients attending antenatal clinics at a Sydney hospital. Most of the users took proprietary analgesic powders. In Group I, 64% of patients had been regular consumers of salicylates for more than 5 years, in Group II, this figure was 44%. Control subjects were 114 clinic patients who did not take salicylates. Their babies served as controls for the study on fetal effects of maternal salicylate ingestion. Maternal effects In considering these results, it should be noted that many of the regular salicylate users were also heavy smokers. The incidence for smoking was 86% in Group I, 65% in Group II, and 54% for controls. Another possibility is that the observed effects were caused by nonsalicylate constituents of the analgesic powders. The authors observed:

• increased frequency of anaemia during pregnancy (41% in Group I and about 20% for Group II and controls) • increased incidence of complicated deliveries (about 30% for Groups I and II, versus 11% for controls) e increased incidence of a11te- an.d post-partum haemorrhage and of transfusion at deliVer'; • duration of gestation and length of labour were increased but not significantly.

Fetal effects The authors found that, in comparison to control neonates, babies of mothers taking aspirin during pregnancy had:

• significantly lower birth weights and • increased still-birth rate.

What the authors had expected to fmd and did not detect were more frequent congenital anomalies, neonatal hypoglycaemia and bleeding. Despite raised cord-blood levels of salicylate (up to 9mg/ 1 OOml) there was no evidence of bleeding.

'Our findings do not support the suggestion that salicylates are teratogenic, but they do suggest that chronic salicylate ingestion is associated with an increase in perinatal mortality and with decreased intrauterine growth'.

[1] Collins, E. and Turner, G.: I..ancet 2: 335 (23 Aug 1975) [2] Turner, G. and Collins, E.: Ibid p.338