Document Detail

Patent ductus arteriosus, low platelets, cyclooxygenase inhibitors, and intraventricular hemorrhage in very low birth weight preterm infants.
MedLine Citation:
PMID:  23351600     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the risk for intraventricular hemorrhage (IVH) in very low birth weight preterm infants with patent ductus arteriosus (PDA) and low platelet count with treatment with cyclooxygenase (COX) inhibitors.
STUDY DESIGN: Diagnosis and treatment of PDA, as well as risk factors for IVH, were assessed using prospectively collected data of all infants born at a gestational age <32 weeks and with a birth weight ≤ 1500 g at Innsbruck University Hospital (January 2003-December 2009). Infants with severe thrombocytopenia (<50 × 10(9)/L) were excluded from analysis.
RESULTS: Sixty-five (20%) of the 325 infants had IVH, and 149 (45.9%) of the 325 were treated with COX inhibitors. Treatment of PDA with COX inhibitors was not an independent risk predictor for IVH in preterm infants with platelets ≥ 100 × 10(9)/L. However, COX inhibitors amplified the risk of bleeding in the presence of moderately decreased platelets (50-99 × 10(9)/L) on days of life 2-7. Multivariable OR for IVH were 0.89 [95% CI 0.43-1.87] for patients with platelets ≥ 100 × 10(9)/L and treatment with COX inhibitors, 3.40 [95% CI 1.13-10.29] for those with moderately decreased platelets without treatment, and 53.3 [95% CI 5.9-484] for patients with both moderately decreased platelets and COX inhibitor treatment compared with those with platelets ≥ 100 × 10(9)/L and no treatment (reference group) (P < .001).
CONCLUSION: In very low birth weight infants with moderate thrombocytopenia treatment with COX inhibitors increased the risk for intracerebral bleeding. Any benefits of this therapy should be carefully balanced against this potential hazard.
Barbara Brunner; Michaela Hoeck; Elisabeth Schermer; Werner Streif; Ursula Kiechl-Kohlendorfer
Publication Detail:
Type:  Journal Article     Date:  2013-01-23
Journal Detail:
Title:  The Journal of pediatrics     Volume:  163     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-26     Completed Date:  2013-09-03     Revised Date:  2014-03-10    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  23-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
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MeSH Terms
Cerebral Hemorrhage / epidemiology,  etiology*
Cyclooxygenase Inhibitors / therapeutic use*
Ductus Arteriosus, Patent / complications*,  drug therapy*
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / epidemiology,  etiology*
Infant, Very Low Birth Weight
Prospective Studies
Risk Assessment
Thrombocytopenia / complications*
Reg. No./Substance:
0/Cyclooxygenase Inhibitors
Comment In:
J Pediatr. 2014 Feb;164(2):429   [PMID:  24315506 ]
J Pediatr. 2014 Feb;164(2):429   [PMID:  24314438 ]
J Pediatr. 2013 Jul;163(1):8-10   [PMID:  23474275 ]

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

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