Outcomes following indomethacin prophylaxis in extremely preterm infants in an all-referral NICU

T. D. Nelin, E. Pena, T. Giacomazzi, S. Lee, J. W. Logan, M. Moallem, R. Bapat, E. G. Shepherd, L. D. Nelin

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Abstract

Objective: We examined data from a contemporary cohort of extreme prematurity (EP) infants admitted to an all-referral Children's Hospital neonatal intensive care unit (NICU) to determine whether prophylactic indomethacin (PI) may continue to benefit these patients. Study Design: An observational study utilizing the small baby ICU data registry that was queried for all EP infants admitted between 2005 and 2014 with documentation of PI use (671 total EP infants; 141 (21%) did not receive PI (control); 530 (79%) received PI (PI). This cohort of EP infants was born at outside hospitals and transferred to our level IV NICU with a mean age on admission of 13 days, well after the PI would have been administered. Results: No difference existed between the control and PI groups in gestational age, birth weight, severity of illness, other in-hospital outcomes or developmental delay. PI infants had a significantly lower mortality rate (P=0.0004), lower relative risk (RR) for mortality 0.52 (95% confidence interval (CI) 0.37 to 0.73, P=0.0001) and lower RR of developing the combined outcome of death or bronchopulmonary dysplasia (RR 0.91, 95% CI 0.85 to 0.98, P=0.012) when compared with the control group. Notably, there was no significant effect of PI on incidence of severe intraventricular hemorrhage or patent ductus arteriosus ligation. Conclusion: PI administration was associated with improved survival in EP infants referred to a level IV Children's Hospital NICU.

Original languageEnglish (US)
Pages (from-to)932-937
Number of pages6
JournalJournal of Perinatology
Volume37
Issue number8
DOIs
StatePublished - Aug 1 2017

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Nelin, T. D., Pena, E., Giacomazzi, T., Lee, S., Logan, J. W., Moallem, M., Bapat, R., Shepherd, E. G., & Nelin, L. D. (2017). Outcomes following indomethacin prophylaxis in extremely preterm infants in an all-referral NICU. Journal of Perinatology, 37(8), 932-937. https://doi.org/10.1038/jp.2017.71