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Does Ibuprofen increase neonatal hyperbilirubinemia?
Enrico Zecca1, Costantino Romagnoli, Maria Pia De Carolis
1Division of Neonatology, Department of Pediatrics, University Hospital A Gemelli, Catholic University of the Sacred Heart, Rome, Italy. enrizecca@rm.unicatt.it
Pediatrics
|July 22, 2009
Summary
Ibuprofen exposure in preterm infants was linked to higher bilirubin levels and increased need for phototherapy. This suggests a potential impact on infant jaundice management and treatment duration.
Area of Science:
- Neonatal Medicine
- Pharmacology
Background:
- Ibuprofen is used to prevent patent ductus arteriosus in preterm infants.
- Hyperbilirubinemia is a common concern in neonates.
Purpose of the Study:
- To investigate the association between ibuprofen exposure and hyperbilirubinemia in preterm infants.
Main Methods:
- Retrospective comparison of 418 infants receiving ibuprofen prophylaxis (2000-2007) versus 288 infants not exposed (1993-1999).
- Infants were all less than 30 weeks of gestation.
Main Results:
- The ibuprofen group showed significantly higher peak total serum bilirubin levels (9.0 vs 7.3 mg/dL).
- Increased need for and duration of phototherapy was observed in the ibuprofen group.
- No significant differences were found in gestational age, birth weight, G6PD deficiency, hypoalbuminemia, hemolytic isoimmunization, or exchange-transfusion rates.
Conclusions:
- Ibuprofen administration is associated with elevated peak total serum bilirubin levels in preterm infants.
- This can lead to more pronounced hyperbilirubinemia and necessitate longer phototherapy.
- Competition in the hepatic glucuronidation pathway is a potential mechanism.
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