Related Experiment Video

Updated: Jun 12, 2025

Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
09:36

Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers

Published on: July 28, 2022

2.2K

Spontaneous Intestinal Perforation in Extremely Premature Infants Exposed to Early Low-Dose Hydrocortisone

Gilles Cambonie1,2, Anais Jouffrey1, Benoit Tessier3,4

  • 1Department of Neonatal Medicine, Pediatric Intensive Care and Pediatric Emergency Transport Service, Arnaud de Villeneuve Hospital, Montpellier University Hospital Centre, University of Montpellier, Montpellier, France.

Acta Paediatrica (Oslo, Norway : 1992)
|June 11, 2025
PubMed

Insights

Early hydrocortisone and ibuprofen treatment in premature infants (<28 weeks) increases the risk of spontaneous intestinal perforation (SIP). This combination therapy requires careful consideration due to potential adverse outcomes in extremely preterm neonates.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) and persistent ductus arteriosus (PDA) are common in infants <28 weeks gestational age (GA).
  • Early low-dose hydrocortisone (ELH) is used to prevent BPD, while ibuprofen treats PDA.
  • The combined effect of ELH and ibuprofen on spontaneous intestinal perforation (SIP) risk is not fully understood.

Purpose of the Study:

  • To evaluate the incidence of SIP in infants <28 weeks GA exposed to ELH.
  • To assess the risk of SIP in infants exposed to both ELH and early ibuprofen treatment for PDA.

Main Methods:

  • Observational study comparing infants exposed and non-exposed to ELH.
  • Matching on key neonatal factors (delivery mode, GA, birthweight, sex).
  • Multivariate logistic regression analysis to determine risk factors for SIP.

Main Results:

  • Infants exposed to ELH had a higher SIP rate (8.1% vs. 2.9%).
  • Concomitant treatment with ELH and ibuprofen further increased SIP risk (11.8% vs. 3.8%).
  • Logistic regression confirmed increased SIP risk with combined ELH and ibuprofen (OR 2.93 [1.24-6.93]).

Conclusions:

  • Early concomitant treatment with ELH and ibuprofen is associated with a significantly increased risk of SIP.
  • This finding highlights a potential safety concern for this combination therapy in extremely preterm infants.
  • Further research may be needed to optimize treatment strategies for BPD and PDA while minimizing SIP risk.
Abstract

Keywords:
bronchopulmonary dysplasiaextremely premature infanthydrocortisoneibuprofenintestinal perforation

More Related Videos

Intratracheal Instillation of Stem Cells in Term Neonatal Rats04:27

Intratracheal Instillation of Stem Cells in Term Neonatal Rats

Published on: May 4, 2020

5.6K
Testing Epithelial Permeability in Fetal Tissue-Derived Enteroids07:51

Testing Epithelial Permeability in Fetal Tissue-Derived Enteroids

Published on: June 16, 2022

2.0K

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
97
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
68
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
45
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
148