Document Detail


Antenatal indomethacin tocolysis is associated with an increased need for surgical ligation of patent ductus arteriosus in preterm infants.
MedLine Citation:
PMID:  20500951     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the effect of antenatal indomethacin (AI) exposure on the incidence, response to postnatal indomethacin (PI), and need for surgical ligation of patent ductus arteriosus (PDA) in preterm infants. METHODS: We performed a retrospective matched cohort study of infants born at < or = 30 weeks' gestation after exposure to AI administered because of preterm labour. Control subjects were infants unexposed to AI but with similar gestational age and birth weight. We compared the incidence of PDA, response to treatment with PI, and surgical PDA ligation rate between the two groups. RESULTS: There was no difference in the incidence of PDA between AI infants (67.6%) and control subjects (66.6%). Only 22 of 54 (41%) infants in the AI group responded to PI therapy for symptomatic PDA closure, compared to 34 of 52 (65%) infants in the control group (P = 0.012). Thirty-two (59%) infants in the AI group required surgical PDA ligation after indomethacin therapy, compared with 18 infants in the control group (35%) (P = 0.01). Multivariate logistic regression analysis showed that AI exposure was independently associated with surgical ligation of PDA (adjusted odds ratio 3.07; 95% CI 1.46 to 6.45). CONCLUSION: In infants born preterm (< or = 30 weeks) with a PDA, antenatal exposure to indomethacin was associated with an increased rate of therapeutic failure of PI and an increased rate of surgical PDA ligation compared with controls without such antenatal exposure.
Authors:
Amuchou S Soraisham; Stacey Dalgleish; Nalini Singhal
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC     Volume:  32     ISSN:  1701-2163     ISO Abbreviation:  J Obstet Gynaecol Can     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101126664     Medline TA:  J Obstet Gynaecol Can     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  435-42     Citation Subset:  IM    
Affiliation:
Department of Pediatrics and Institute of Child and Maternal Health Faculty of Medicine, University of Calgary, Calgary AB, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Cohort Studies
Ductus Arteriosus, Patent / surgery*
Female
Humans
Indomethacin / adverse effects*
Infant, Newborn
Infant, Premature*
Ligation
Male
Premature Birth / prevention & control
Retrospective Studies
Tocolytic Agents / adverse effects*
Chemical
Reg. No./Substance:
0/Tocolytic Agents; 53-86-1/Indomethacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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