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Outcomes in infants < 29 weeks of gestation following single-dose prophylactic indomethacin

Journal of Perinatology volume 41, pages 109–118 (2021)Cite this article

Subjects

Abstract

Background

Prophylactic indomethacin (3 doses) decreases patent ductus arteriosus (PDA) and intraventricular hemorrhage (IVH) in preterm infants. The study aim was to determine whether single-dose indomethacin (SD-INDO) decreases PDA, IVH, and improves motor function.

Methods

A retrospective cohort (2007–2014) compared infants born < 29 weeks who did (n = 299) or did not (n = 85) receive SD-INDO and estimated outcomes association with ordinal logistic regression, adjusting for multiple variables using propensity scores.

Results

Infants who received SD-INDO were more premature (p < 0.001) but had lower odds of PDA (OR 0.26 [0.15, 0.44], p < 0.005), PDA receiving treatment (OR 0.12 [0.03, 0.47], p < 0.005), death (OR 0.41 [0.20, 0.86], p = 0.02), and CP severity (OR 0.33 [0.12, 0.89], p = 0.03). There was less IVH (OR 0.58 [0.36, 0.94], p = 0.03) when adjusted for gestational age.

Conclusions

SD-INDO is associated with decreased PDA and CP severity and improved survival.

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Fig. 1: Study flow diagram.

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Funding

Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH) (MGK) and National Institutes of Health HL109199 and HL128386 (JR).

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Author notes

  1. These authors contributed equally: Jeff Reese and Nathalie L. Maitre

Authors and Affiliations

  1. Mildred T. Stahlman Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA

    Maria Gillam-Krakauer, Robert B. Cotton & Jeff Reese

  2. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA

    James C. Slaughter

  3. Vanderbilt University Medical Center, Nashville, TN, USA

    Blaine E. Robinson

  4. Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, TN, USA

    Jeff Reese

  5. Department of Pediatrics Nationwide Children’s Hospital, Columbus, OH, USA

    Nathalie L. Maitre

  6. Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA

    Nathalie L. Maitre

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  1. Maria Gillam-Krakauer
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  2. James C. Slaughter
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  3. Robert B. Cotton
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  4. Blaine E. Robinson
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  6. Nathalie L. Maitre
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Contributions

MGK designed the study, performed the data collection, and wrote and revised the manuscript. RBC designed the study. CS performed statistical analysis. BR performed data collection. JR designed the study and revised the manuscript. NM designed the study, performed the data collection and performed statistical analysis.

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Correspondence to Maria Gillam-Krakauer.

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Gillam-Krakauer, M., Slaughter, J.C., Cotton, R.B. et al. Outcomes in infants < 29 weeks of gestation following single-dose prophylactic indomethacin. J Perinatol 41, 109–118 (2021). https://doi.org/10.1038/s41372-020-00814-9

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