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

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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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Gillam-Krakauer, M., Slaughter, J. C., Cotton, R. B., Robinson, B. E., Reese, J., & Maitre, N. L. (2021). Outcomes in infants < 29 weeks of gestation following single-dose prophylactic indomethacin. Journal of Perinatology, 41(1), 109–118. https://doi.org/10.1038/s41372-020-00814-9

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