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  • Original Article
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Outcomes following indomethacin prophylaxis in extremely preterm infants in an all-referral NICU

Abstract

Objective:

We examined data from a contemporary cohort of extreme prematurity (EP) infants admitted to an all-referral Children’s Hospital neonatal intensive care unit (NICU) to determine whether prophylactic indomethacin (PI) may continue to benefit these patients.

Study Design:

An observational study utilizing the small baby ICU data registry that was queried for all EP infants admitted between 2005 and 2014 with documentation of PI use (671 total EP infants; 141 (21%) did not receive PI (control); 530 (79%) received PI (PI). This cohort of EP infants was born at outside hospitals and transferred to our level IV NICU with a mean age on admission of 13 days, well after the PI would have been administered.

Results:

No difference existed between the control and PI groups in gestational age, birth weight, severity of illness, other in-hospital outcomes or developmental delay. PI infants had a significantly lower mortality rate (P=0.0004), lower relative risk (RR) for mortality 0.52 (95% confidence interval (CI) 0.37 to 0.73, P=0.0001) and lower RR of developing the combined outcome of death or bronchopulmonary dysplasia (RR 0.91, 95% CI 0.85 to 0.98, P=0.012) when compared with the control group. Notably, there was no significant effect of PI on incidence of severe intraventricular hemorrhage or patent ductus arteriosus ligation.

Conclusion:

PI administration was associated with improved survival in EP infants referred to a level IV Children’s Hospital NICU.

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Correspondence to L D Nelin.

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Nelin, T., Pena, E., Giacomazzi, T. et al. Outcomes following indomethacin prophylaxis in extremely preterm infants in an all-referral NICU. J Perinatol 37, 932–937 (2017). https://doi.org/10.1038/jp.2017.71

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