Indomethacin tocolysis and white matter injury in preterm infants.
OBJECTIVE
This study aims to clarify the relationship between indomethacin tocolysis and neonatal white matter injury (WMI) in preterm infants.


METHODS
We conducted a retrospective review of preterm infants born at 24-32 weeks who had sufficient cranial ultrasound examinations (CUS) to determine the incidence and severity of abnormalities. Infants with normal CUS were compared on univariate and multivariate analyses with infants with the different forms of WMI.


RESULTS
On multivariate logistic regression analysis, indomethacin tocolysis was significantly correlated with periventricular echogenicity (PVE; OR 2.84 95% CI 1.41-5.7, p = 0.003), but not with periventricular leucomalacia (PVL; OR 1.83 95% CI0.6-5.6, p = 0.29). Indomethacin was not related to increased risk for periventricular-intraventricular hemorrhage or periventricular hemorrhagic infarction.


CONCLUSIONS
These findings suggest caution in the use of indomethacin as a tocolytic therapy.
Friedman
S
S
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel.
Flidel-Rimon
O
O
Steinberg
M
M
Shinwell
E S
ES
D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000009:adverse effects*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D015149:Tocolytic Agents / Q000009:adverse effects*
D015149:Tocolytic Agents; D007213:Indomethacin