title: The effect of in utero exposure to indomethacin on the need for surgical closure of a patent ductus arteriosus in the neonate.
abstract: OBJECTIVE
  Our purpose was to determine the effect of in utero exposure to indomethacin on the need for surgical closure of a patent ductus arteriosus (PDA).
  
  
  METHODS
  Perinatal variables were compared between infants at <32 weeks who required surgical closure of PDA after failed medical management and those who did not. Statistical analysis was performed by Student t, Mann-Whitney, chi(2), and multiple logistic regression tests.
  
  
  RESULTS
  Eight of 77 infants with PDA failed therapy and required surgery. Maternal demographics, gestational age, birth weight, and delivery route were similar in both groups. In utero exposure to indomethacin was more common in neonates requiring surgery versus those who did not, particularly when exposure was for >72 hours (50.0% vs 8.7%, odds ratio 10.5, 95% CI 1.6-72.1, P =.008).
  
  
  CONCLUSIONS
  Need for surgical closure of PDA appears to be increased by in utero indomethacin exposure. These findings should be considered in the overall context of the risk versus benefits of tocolysis.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Victor R
authors.initials: VR
authors.lastname: Suarez
authors.forename: Lauree L
authors.initials: LL
authors.lastname: Thompson
authors.forename: Venu
authors.initials: V
authors.lastname: Jain
authors.forename: Gayle L
authors.initials: GL
authors.lastname: Olson
authors.forename: Gary D V
authors.initials: GD
authors.lastname: Hankins
authors.forename: Michael A
authors.initials: MA
authors.lastname: Belfort
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000009:adverse effects* / Q000627:therapeutic use; D007231:Infant, Newborn; D011247:Pregnancy; D012720:Severity of Illness Index
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin