Necrotizing enterocolitis in preterm infants with patent ductus arteriosus: Does indomethacin increase the risk?

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Scott J. Richter, Professor (Creator)
The University of North Carolina at Greensboro (UNCG )
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Abstract: Objectives: To examine any association of necrotizing enterocolitis (NEC) and intestinal perforation (IP) in very low birth weight neonates with indomethacin treatment, cumulative dose or maximum plasma concentrations. Methods: This is a retrospective 9-year cohort study of very low birth weight infants ( < 1500 grams) admitted to our neonatal intensive care unit. The incidence of NEC and IP in infants who received indomethacin for a PDA (N = 228) were compared to control infants who did not have PDA and received no indomethacin (S = 628). Factors which were statisticaily significant in a univariate analysis were then included in a logistic regression model to determine their significance. Results: NEC occurred in 14 (6.1 %) indomethacin-treated infants compared to 47 (7.5%) control infants. When the incidence of NEC or IP was restricted to events occurring within 14 days of indomethacin, infants (1.7%) had NEC. JP occurred in 14 (6.1 %) indomethacin-treated infants, but 10 had concurrent steroid therapy. IP also occurred in 4 (0.6%) controls. Multivariate logistical regression revealed a lower risk of NEC with indomethacin. The risk for NEC and IP is not increased with higher INDO doses or INDO concentrations. Conclusions: Indomethacin treatment for PDA does not increase NEC risk, and may decrease the risk. Indomethacin treatment is associated with an increased risk of IP, especially when combined with systemic glucocorticoids.

Additional Information

Journal of Neonatal-Perinatal Medicine, 1(4), 209-216
Language: English
Date: 2008
Indomethacin, necrotizing enterocolitis, intestinal perforation, neonates, patent ductus arteriosus

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