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Outcomes in infants < 29 weeks of gestation following single-dose prophylactic indomethacin

Maria Gillam-Krakauer1, James C Slaughter2, Robert B Cotton3

  • 1Mildred T. Stahlman Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. Maria.Krakauer@vumc.org.

Journal of Perinatology : Official Journal of the California Perinatal Association
|September 19, 2020
PubMed

Insights

Single-dose indomethacin (SD-INDO) in preterm infants is linked to fewer cases of patent ductus arteriosus (PDA) and reduced cerebral palsy (CP) severity. This treatment also appears to improve survival rates in this vulnerable population.

Area of Science:

  • Neonatalogy
  • Pediatric Pharmacology
  • Clinical Research

Background:

  • Prophylactic indomethacin, administered in multiple doses, is known to decrease patent ductus arteriosus (PDA) and intraventricular hemorrhage (IVH) in preterm infants.
  • The efficacy of a single-dose regimen remains an area of investigation for neonatal care.

Purpose of the Study:

  • To evaluate the impact of a single-dose indomethacin (SD-INDO) regimen on PDA and IVH rates in preterm infants.
  • To determine if SD-INDO influences motor function and overall survival in this population.

Main Methods:

  • A retrospective cohort study was conducted between 2007 and 2014.
  • Infants born before 29 weeks of gestation who received SD-INDO (n=299) were compared to those who did not (n=85).
  • Ordinal logistic regression and propensity score matching were used to adjust for confounding variables.

Main Results:

  • SD-INDO was associated with significantly lower odds of PDA (OR 0.26) and treated PDA (OR 0.12).
  • A reduction in the severity of cerebral palsy (CP) (OR 0.33) and intraventricular hemorrhage (IVH) (OR 0.58) was observed.
  • Infants receiving SD-INDO had improved survival rates (OR 0.41).

Conclusions:

  • Single-dose indomethacin (SD-INDO) is associated with decreased rates of PDA and reduced CP severity in preterm infants.
  • The findings suggest that SD-INDO may improve survival outcomes in this high-risk group.
Abstract

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