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Effects of prophylactic indomethacin on intraventricular hemorrhage and adverse outcomes in neonatal intensive care unit

Journal of Perinatology volume 42, pages 1644–1648 (2022)Cite this article

Subjects

Abstract

Objective

To identify the relationship between prophylactic indomethacin (PI) administration and incidence of intraventricular hemorrhage.

Study design

A retrospective analysis of extremely premature infants <27 weeks gestational age born between January 2014 and September 2020.

Results

A total of 421 infants were included from three of Nationwide Children’s Hospital delivery centers. Of those 255 (61%) received PI. After adjustment by inverse proportionality treatment weighting (IPTW), no differences were found in incidence of intraventricular hemorrhage (IVH) at the time of the first ultrasound, 31% vs. 33% in PI and control groups respectively (p = 0.68). The rate of rise of serum creatinine from baseline to day of life four was significantly higher in the PI group (0.14 mg/dl PI and 0.03 mg/dl control, p < 0.001).

Conclusion

PI was not associated with any benefit in prevention of IVH, but is associated with adverse effects including acute rise in creatinine.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due patient privacy but are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Pharmacy, Nationwide Children’s Hospital, Columbus, OH, USA

    Colleen J. Miller, Pavel Prusakov, Jacqueline Magers, Hana Sacic & Kelsi Escobar

  2. Department of Pharmacy, Riverside Methodist Hospital, Columbus, OH, USA

    Sunday Speaks

  3. Biostatistics Resource at Nationwide Children’s Hospital (BRANCH), Center for Biostatistics, Ohio State University Medical Center, Columbus, OH, USA

    Mahmoud Abdel-Rasoul

  4. The Ohio State University College of Medicine, Columbus, OH, USA

    Leif D. Nelin

  5. Division of Neonatology, Nationwide Children’s Hospital, Columbus, OH, USA

    Leif D. Nelin

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  1. Colleen J. Miller
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  2. Pavel Prusakov
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  7. Mahmoud Abdel-Rasoul
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  8. Leif D. Nelin
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Contributions

CJM and PP designed the study, collected, analyzed, interpreted the data, and drafted the manuscript. JM, MAR, and LDN designed the study, interpreted the data, and critically revised the manuscript for important intellectual content. KE, HS, and SS collected patient data and revised the manuscript for important intellectual content. All authors approved the final version of the manuscript to be published.

Corresponding author

Correspondence to Colleen J. Miller.

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The authors declare no competing interests.

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Miller, C.J., Prusakov, P., Magers, J. et al. Effects of prophylactic indomethacin on intraventricular hemorrhage and adverse outcomes in neonatal intensive care unit. J Perinatol 42, 1644–1648 (2022). https://doi.org/10.1038/s41372-022-01441-2

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