Document Detail


Indomethacin responsiveness of patent ductus arteriosus and renal abnormalities in preterm infants treated with indomethacin.
MedLine Citation:
PMID:  12970633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We evaluated the factors related to indomethacin responsiveness of the patent ductus arteriosus (PDA) and subsequent renal and electrolyte abnormalities in a large number of low birth weight infants. METHODS: The ductus was evaluated by Doppler echocardiogram or clinical signs after the last administration of indomethacin for 2538 low birth weight infants, through the use of postmarketing surveillance data. RESULTS: Multivariate logistic regression analyses demonstrated that clinical closure of PDA was significantly associated with pregnancy-induced hypertension and respiratory distress syndrome. In contrast, a 1-point increase of cardiovascular dysfunction score or a 1-day increase in postnatal age at the first indomethacin treatment decreased the responsiveness of the ductus to indomethacin. Clinical ductal reopening was significantly less likely to occur for each week of increased gestational age. Ductal reopening was more likely for each day of postnatal life at the first administration of indomethacin. Infants with preexisting renal and electrolyte abnormalities and infants whose mothers had received indomethacin tocolysis or who had chorioamnionitis were at increased risk of development of renal impairment. CONCLUSIONS: Both antenatal and postnatal factors predict good or poor response to indomethacin therapy for PDA.
Authors:
Kazuo Itabashi; Tsutomu Ohno; Hiroshi Nishida
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  143     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-09-12     Completed Date:  2003-10-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203-7     Citation Subset:  AIM; IM    
Affiliation:
Children's Medical Center, Northern Yokohama Hospital, 35-1 Chigasakityuo, Tsuzukiku, Yokohama 224-8503, Japan. kitaba@med.showa-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Agents / administration & dosage,  adverse effects*,  therapeutic use*
Chorioamnionitis
Ductus Arteriosus, Patent / drug therapy*
Echocardiography, Doppler
Female
Humans
Indomethacin / administration & dosage,  adverse effects*,  therapeutic use*
Infant, Low Birth Weight*
Infant, Newborn
Infant, Premature, Diseases / drug therapy*
Kidney Diseases / chemically induced
Male
Multivariate Analysis
Pregnancy
Pregnancy Complications
Water-Electrolyte Imbalance / chemically induced
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 53-86-1/Indomethacin

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