Document Detail


Spontaneous intestinal perforation in extremely low birth weight infants: association with indometacin therapy and effects on neurodevelopmental outcomes at 18-22 months corrected age.
MedLine Citation:
PMID:  22684157     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spontaneous intestinal perforation (SIP) is associated with the use of postnatal glucocorticoids and indometacin in extremely low birth weight (ELBW) infants. The authors hypothesised: 1) an association of SIP with the use of antenatal steroids (ANS) and indometacin either as prophylaxis for intraventricular hemorrhage (IVH) (P Indo) or for treatment of PDA (Indo/PDA) and 2) an increased risk of death or abnormal neurodevelopmental outcomes in infants with SIP at 18-22 months corrected age.
DESIGN/METHODS: The authors retrospectively identified ELBW infants with SIP in the Neonatal Research Network's generic database. Unadjusted analysis identified the differences in maternal, neonatal and clinical variables between infants with and without SIP. Logistic regression analysis identified the adjusted OR for SIP with reference to ANS, P Indo and Indo/PDA. Neurodevelopmental outcomes were assessed among survivors at 18-22 months corrected age.
RESULTS: Indo/PDA was associated with an increased risk of SIP (adjusted OR 1.61; 95% CI 1.25 to 2.08), while P Indo and ANS were not. SIP was independently associated with an increased risk of death or neurodevelopmental impairment (NDI) (adjusted OR 1.85; 95% CI 1.32 to 2.60) and NDI among survivors (adjusted OR 1.75, 95% CI 1.20 to 2.55).
CONCLUSION: Indometacin used for IVH prophylaxis and ANS were not associated with the occurrence of SIP in ELBW infants. Indometacin used for treatment of symptomatic PDA was however associated with an increased risk of SIP. ELBW infants with SIP have an increased risk of poor neurodevelopmental outcomes.
Authors:
Rajan Wadhawan; William Oh; Betty R Vohr; Shampa Saha; Abhik Das; Edward F Bell; Abbott Laptook; Seetha Shankaran; Barbara J Stoll; Michele C Walsh; Rose Higgins
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-06-09
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  98     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-18     Completed Date:  2013-05-02     Revised Date:  2013-08-30    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F127-32     Citation Subset:  AIM; IM    
Affiliation:
Division of Neonatology, All Children’s Hospital, St Petersburg, Florida, USA. Rajan.Wadhawan.MD@flhosp.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents, Non-Steroidal / adverse effects*,  therapeutic use
Developmental Disabilities / chemically induced
Ductus Arteriosus, Patent / drug therapy
Female
Humans
Indomethacin / adverse effects*,  therapeutic use
Infant, Extremely Low Birth Weight*
Infant, Extremely Premature
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / drug therapy*
Intestinal Perforation / chemically induced*
Intracranial Hemorrhages / prevention & control
Male
Retrospective Studies
Young Adult
Grant Support
ID/Acronym/Agency:
M01 RR002635/RR/NCRR NIH HHS; M01 RR125/RR/NCRR NIH HHS; M01 RR16587/RR/NCRR NIH HHS; M01 RR2172/RR/NCRR NIH HHS; M01 RR2635/RR/NCRR NIH HHS; M01 RR30/RR/NCRR NIH HHS; M01 RR32/RR/NCRR NIH HHS; M01 RR39/RR/NCRR NIH HHS; M01 RR44/RR/NCRR NIH HHS; M01 RR6022/RR/NCRR NIH HHS; M01 RR633/RR/NCRR NIH HHS; M01 RR70/RR/NCRR NIH HHS; M01 RR7122/RR/NCRR NIH HHS; M01 RR750/RR/NCRR NIH HHS; M01 RR80/RR/NCRR NIH HHS; M01 RR8084/RR/NCRR NIH HHS; M01 RR997/RR/NCRR NIH HHS; U01 HD36790/HD/NICHD NIH HHS; U10 HD21364/HD/NICHD NIH HHS; U10 HD21373/HD/NICHD NIH HHS; U10 HD21385/HD/NICHD NIH HHS; U10 HD21397/HD/NICHD NIH HHS; U10 HD21415/HD/NICHD NIH HHS; U10 HD27851/HD/NICHD NIH HHS; U10 HD27853/HD/NICHD NIH HHS; U10 HD27856/HD/NICHD NIH HHS; U10 HD27871/HD/NICHD NIH HHS; U10 HD27880/HD/NICHD NIH HHS; U10 HD27904/HD/NICHD NIH HHS; U10 HD34167/HD/NICHD NIH HHS; U10 HD34216/HD/NICHD NIH HHS; U10 HD40461/HD/NICHD NIH HHS; U10 HD40492/HD/NICHD NIH HHS; U10 HD40498/HD/NICHD NIH HHS; U10 HD40521/HD/NICHD NIH HHS; U10 HD40689/HD/NICHD NIH HHS; U10 HD53089/HD/NICHD NIH HHS; UL1 RR24139/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 53-86-1/Indomethacin
Comments/Corrections

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