Prophylactic indomethacin reduces grades III and IV intraventricular hemorrhages when compared to early indomethacin treatment of a patent ductus arteriosus.
OBJECTIVE
To determine the relative risk of severe intraventricular hemorrhage (IVH) between two very early indomethacin treatment strategies.


METHODS
Retrospective chart review of infants <29 weeks gestation and <1350 g who received either indomethacin prophylaxis or very early echocardiography with indomethacin treatment only if the ductus arteriosus was patent.


RESULTS
A total of one hundred and two infants received prophylactic indomethacin (pINDO). Echochardiography was performed on 158 infants, of whom 117 received indomethacin. Infants receiving pINDO had lower gestational age, but similar birth weight, gender, race, antenatal steroid exposure, delivery mode, Apgar scores, and need for resuscitation as infants evaluated by echocardiography. Grades III to IV IVH was observed less frequently in infants who received pINDO (OR 0.27, 95% CI 0.10 to 0.77, p=0.014). Frequency of side effects and recurrent patent ductus arteriosus did not differ between treatment groups.


CONCLUSIONS
pINDO reduces severe IVH when compared to an early echocardiography strategy.
Yanowitz
Toby Debra
TD
University of Pittsburgh School of Medicine and the Magee-Womens Research Institute, Pittsburgh, PA 15213, USA.
Baker
Robyn Wyman
RW
Sobchak Brozanski
Beverly
B
D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004374:Ductus Arteriosus, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage* / Q000627:therapeutic use*; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
D002317:Cardiovascular Agents; D007213:Indomethacin