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Prophylactic Indomethacin Reduces Grades III and IV Intraventricular Hemorrhages when Compared to Early Indomethacin Treatment of a Patent Ductus Arteriosus

Journal of Perinatology volume 23, pages 317–322 (2003)Cite this article

Abstract

OBJECTIVE: To determine the relative risk of severe intraventricular hemorrhage (IVH) between two very early indomethacin treatment strategies.

STUDY DESIGN: Retrospective chart review of infants <29 weeks gestation and <1350 g who received either indomethacin prophylaxis or very early echocardiography with indomethacin treatment only if the ductus arteriosus was patent.

RESULTS: A total of one hundred and two infants received prophylactic indomethacin (pINDO). Echochardiography was performed on 158 infants, of whom 117 received indomethacin. Infants receiving pINDO had lower gestational age, but similar birth weight, gender, race, antenatal steroid exposure, delivery mode, Apgar scores, and need for resuscitation as infants evaluated by echocardiography. Grades III to IV IVH was observed less frequently in infants who received pINDO (OR 0.27, 95% CI 0.10 to 0.77, p=0.014). Frequency of side effects and recurrent patent ductus arteriosus did not differ between treatment groups.

CONCLUSION: pINDO reduces severe IVH when compared to an early echocardiography strategy.

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Authors and Affiliations

  1. University of Pittsburgh School of Medicine and the Magee-Womens Research Institute, Pittsburgh, PA, USA

    Toby Debra Yanowitz MD, Robyn Wyman Baker BSN, CRNP & Beverly Sobchak Brozanski MD

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  1. Toby Debra Yanowitz MD
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  2. Robyn Wyman Baker BSN, CRNP
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  3. Beverly Sobchak Brozanski MD
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Supported by NIH K23 HD01317

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Yanowitz, T., Baker, R. & Sobchak Brozanski, B. Prophylactic Indomethacin Reduces Grades III and IV Intraventricular Hemorrhages when Compared to Early Indomethacin Treatment of a Patent Ductus Arteriosus. J Perinatol 23, 317–322 (2003). https://doi.org/10.1038/sj.jp.7210893

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