Antenatal magnesium sulfate and the postnatal response of the ductus arteriosus to indomethacin in extremely preterm neonates.
OBJECTIVE
The aim of this study is to evaluate the influence of antenatal magnesium sulfate (MgSO(4)) treatment on the clinical responsiveness of the ductus arteriosus to indomethacin prophylaxis and on that of symptomatic patent ductus arteriosus (sPDA) to indomethacin treatment in premature neonates.


METHODS
This is a retrospective study of 160 consecutively admitted neonates with a gestational age of <28 weeks (41 MgSO(4) exposed and 119 controls) who received indomethacin prophylaxis.


RESULTS
Incidence of early closure of the ductus arteriosus was lower in the MgSO(4)-exposed neonates than in the control group (59 vs 84%, respectively; P=0.002), whereas incidence of an sPDA was higher (46 vs 24%, respectively; P=0.006). Response to indomethacin treatment was similar between the two groups. Logistic regression analysis indicated increased risk of failure of early ductus arteriosus closure following antenatal MgSO(4) treatment (odds ratio, 4.03; P=0.002).


CONCLUSIONS
In extremely preterm neonates, antenatal MgSO(4) treatment reduces clinical responsiveness of the ductus arteriosus to indomethacin prophylaxis but not that of sPDA to indomethacin treatment.
Katayama
Y
Y
Division of Neonatology, Department of Pediatrics, Takatsuki General Hospital, Takatsuki City, Osaka, Japan. katayama@ajk.takatsuki-hp.or.jp
Minami
H
H
Enomoto
M
M
Takano
T
T
Hayashi
S
S
Lee
Y K
YK
D004334:Drug Administration Schedule; D004373:Ductus Arteriosus / Q000187:drug effects*; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007213:Indomethacin / Q000008:administration & dosage*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control; D016015:Logistic Models; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care; D012189:Retrospective Studies; D015149:Tocolytic Agents / Q000008:administration & dosage*; D016896:Treatment Outcome
D015149:Tocolytic Agents; D008278:Magnesium Sulfate; D007213:Indomethacin