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Perinatal indomethacin treatment and neonatal complications in preterm infants
1Department of Paediatrics, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland.
Insights
Antenatal indomethacin use in preterm infants increases risks for intraventricular hemorrhage. Combined antenatal and postnatal exposure is linked to necrotizing enterocolitis and sepsis in neonates.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Perinatology
Background:
- Indomethacin is commonly used to manage preterm labor and patent ductus arteriosus.
- Neonatal complications following indomethacin exposure require further investigation.
Purpose of the Study:
- To evaluate the incidence of neonatal complications in infants exposed to indomethacin.
- To assess risks associated with antenatal, postnatal, and combined indomethacin exposure.
Main Methods:
- Retrospective analysis of 240 preterm infants (23-32 weeks gestational age).
- Evaluation of neonatal complication rates based on indomethacin exposure timing and dosage.
Main Results:
- Antenatal indomethacin >2 days or >/=150 mg correlated with increased Grade I-II intraventricular hemorrhage.
- Combined exposure linked to necrotizing enterocolitis; cumulative exposure associated with sepsis.
Conclusions:
- Antenatal indomethacin may increase risk for intraventricular hemorrhage in preterm infants.
- Combined antenatal and postnatal indomethacin exposure is associated with higher risks of necrotizing enterocolitis and sepsis.
Unlabelled:
To evaluate the incidence of neonatal complications among infants exposed to indomethacin antenatally, postnatally or both ante-and postnatally (combined), the records of 240 infants of gestational ages between 23 to 32 weeks were analysed retrospectively. Antenatal indomethacin treatment for longer than 2 days with a daily or cumulative dosage >/=150 mg correlated with a significantly higher incidence of grade I-II intraventricular haemorrhage. Combined exposure, cumulative antenatal exposure >/=150 mg and duration of antenatal exposure of more than 2 days was associated with necrotising enterocolitis and a cumulative exposure with sepsis. There was no independent association between indomethacin exposure and pneumothorax, bronchopulmonary dysplasia or respiratory distress syndrome.
Conclusion:
Preterm infants with exposure to antenatal indomethacin might be at increased risk of grade I and II intraventricular haemorrhage and those with both ante- and postnatal exposure at an increased risk of necrotising enterocolitis and sepsis.