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A matched case control study with propensity score balancing examining the protective effect of paracetamol against parentally reported apnoea in infants.
MedLine Citation:
PMID:  22178799     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Central apnoea occurs in infants and if not detected leads to death. Central apnoea is a prostaglandin E(2)(PGE2) mediated effect that is susceptible to pharmacologic manipulation in animal models. Paracetamol and ibuprofen are centrally and peripherally acting PGE2 inhibitors respectively. AIM: To determine if infants who had received paracetamol or ibuprofen are relatively protected from apnoea. METHODS: We performed a matched case control study using propensity score balancing to adjust for non-random drug assignment. We included infants from prospective studies of central apnoea and bronchiolitis. We matched on age, prematurity and fever to adjust for the infants' underlying risk of apnoea. The primary outcome measure was odds of exposure to paracetamol or ibuprofen by apneic infants compared to their controls. RESULTS: Forty two apneic and 729 non-apneic infants were identified. Infants with apnoea were younger than those without, median age 6.5 versus 12.2 weeks and were more likely to be premature. These differences were balanced using matching. Differences between those who did and did not receive paracetamol were satisfactorily balanced using the propensity score. Ibuprofen was used too infrequently to analyse it further. In the unadjusted analysis fewer apneic infants had had prior paracetamol use 5/42(12%) versus 211/729(29%) or prior ibuprofen use 1/42(2%) versus 51/729(7%). In the adjusted analysis paracetamol was protective against apnoea; OR 0.30 (95% CI 0.11, 0.78). CONCLUSIONS: Prior paracetamol use was protective against apnoea in infants. We could not demonstrate an effect for ibuprofen.
Authors:
Paul Walsh; Lucas Shanholtzer; Mark Loewen; Kim Trinh; Ben McEnulty; Stephen J Rothenberg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-14
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ireland Ltd.
Affiliation:
Kern Medical Center, Bakersfield, CA; David Geffen School of Medicine, University of California, Los Angeles.
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