Document Detail


Intrauterine inflammation as a risk factor for persistent ductus arteriosus patency after cyclooxygenase inhibition in extremely low birth weight infants.
MedLine Citation:
PMID:  20598319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To test the hypothesis that intrauterine inflammation increases prostaglandin production and may be a risk factor for persistent ductus arteriosus after therapy with indomethacin, a nonselective cyclooxygenase inhibitor. STUDY DESIGN: Indomethacin therapy was started after confirming ductus arteriosus within 24 hours after birth in extremely low birth weight infants. After one cycle of therapy, infants with closed ductus were classified as responders, and those with patent ductus were classified as nonresponders. Multiple logistic regression analysis was used to determine important perinatal factors associated with persistent ductus arteriosus. Immunohistochemistry with cyclooxygenase antibodies and radioimmunoassay by 6-keto prostaglandin F(1α) kit were used to determine the relationship between intrauterine inflammation and ductal patency. RESULTS: Forty-one infants were responders, and 37 infants were nonresponders. Responders were frequently small for gestational age; nonresponders frequently had lower gestational age, respiratory distress syndrome, and intrauterine inflammation. By multiple logistic regression analysis, respiratory distress syndrome and intrauterine inflammation were more frequent in nonresponders. Cyclooxygenase-1 expression in the umbilical arteries and plasma 6-keto prostaglandin F(1α) levels were higher in nonresponders. CONCLUSIONS: Respiratory distress syndrome and intrauterine inflammation were independent risk factors for persistent ductus arteriosus after indomethacin therapy in extremely low-birth weight infants. Intrauterine inflammation may have a negative influence on ductus arteriosus closure via increased cyclooxygenase-1 activity.
Authors:
Eun Sun Kim; Ee-Kyung Kim; Chang Won Choi; Han-Suk Kim; Beyong Il Kim; Jung-Hwan Choi; Joong Shin Park; Kyung Chul Moon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-02
Journal Detail:
Title:  The Journal of pediatrics     Volume:  157     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  745-50.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Affiliation:
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
Cyclooxygenase Inhibitors / therapeutic use*
Ductus Arteriosus, Patent / drug therapy*,  epidemiology,  etiology*
Female
Fetal Diseases*
Humans
Indomethacin / therapeutic use*
Infant, Extremely Low Birth Weight*
Infant, Newborn
Inflammation / complications*
Male
Pilot Projects
Risk Factors
Treatment Failure
Chemical
Reg. No./Substance:
0/Cyclooxygenase Inhibitors; 53-86-1/Indomethacin

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


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