Postnatal administration of indomethacin to preterm infants has been associated with a decreased incidence of severe intraventricular hemorrhage(IVH). However, maternal administration of indomethacin for preterm labor has been associated with increased neonatal complications, including severe IVH. Hypothesis: Antenatal indomethacin decreases the incidence of IVH in extremely premature infants. Method: Records of neonates between 24-28 wks of gestation, born from 1995-1997 to mothers in preterm labor were obtained from the hospital data base. Infants with prolonged premature rupture of membranes (> 18 hrs), no head ultrasound performed or incomplete records were excluded. Demographic variables were evaluated using T-test or Chi-square, as appropriate. Results: 109 infant met inclusion criteria, 26 infants were exposed to indomethacin and 83 were not. There were no difference between the two groups with respect to gestational age, birth weight, route of delivery, Apgar scores and maternal complications. Although the incidence of grades III-IV IVH was lower in the infants exposed to indomethacin (7% vs. 18%), this was not statistically different. There were no difference between the indomethacin-exposed and control groups with regard to incidence of NEC (15% vs. 13%), BPD (56% vs. 60%), PDA (50% vs. 66%), air leak(12% vs 24%), pulmonary hemorrhage (19% vs. 15%) and number of doses of surfactant (2.4% vs. 1.8%). Further analysis revealed that more mothers of indomethacin-exposed infants were given steroids prior to delivery (96% vs 61%, p < 0.001). Antenatal steroid administration was associated with a lower incidence of severe IVH (14% vs 45%, p < 0.001). Conclusion: Antenatal exposure to indomethacin among preterm infants is not associated with lower incidence of severe IVH nor increased occurrence of neonatal complications. Antenatal steroid administration significantly lowers the incidence of severe IVH in these infants.