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Indomethacin tocolysis and intraventricular hemorrhage
R D Suarez1, W A Grobman, B V Parilla
1Section of Maternal-Fetal Medicine and the Department of Obstetrics and Gynecology, Northwestern Memorial Hospital and Evanston Hospital, Northwestern University Medical School, Chicago, Illinois, USA.
Obstetrics and Gynecology
|June 1, 2001
Summary
Indomethacin tocolysis, used to prevent preterm birth, was not found to increase the risk of intraventricular hemorrhage in newborns. This study suggests no significant association between indomethacin use and this common neonatal complication.
Area of Science:
- Neonatalogy
- Perinatology
- Pharmacology
Background:
- Neonatal intraventricular hemorrhage (IVH) is a significant concern in preterm infants.
- Tocolytic agents are used to prolong pregnancy, but their effects on neonatal outcomes require careful evaluation.
Purpose of the Study:
- To investigate the association between indomethacin tocolysis and the incidence of neonatal intraventricular hemorrhage.
- To determine if antenatal indomethacin exposure is a risk factor for IVH in preterm neonates.
Main Methods:
- A case-control study matching 56 preterm neonates with IVH to 224 controls by gestational age.
- Maternal and neonatal charts were reviewed for tocolytic exposure, demographic data, and outcomes.
- Statistical analyses included Student t test, chi(2) analysis, and multivariable logistic regression.
Main Results:
- Infants with IVH were more likely to be born earlier, have lower birth weight, and experience chorioamnionitis, vaginal delivery, sepsis, and respiratory distress syndrome.
- Multivariable analysis identified gestational age, chorioamnionitis, vaginal delivery, and respiratory distress syndrome as significant factors associated with IVH.
- Indomethacin exposure, alone or in combination, was not significantly associated with an increased risk of IVH (adjusted ORs 1.3 and 2.0, respectively).
Conclusions:
- Antenatal exposure to indomethacin as a tocolytic agent is not associated with an increased risk of neonatal intraventricular hemorrhage.
- The findings suggest that indomethacin can be used for tocolysis without significantly elevating the risk of IVH.