Format

Send to

Choose Destination
J Pediatr. 2017 Jul;186:34-40.e2. doi: 10.1016/j.jpeds.2017.02.003. Epub 2017 Feb 28.

Association between Use of Prophylactic Indomethacin and the Risk for Bronchopulmonary Dysplasia in Extremely Preterm Infants.

Collaborators (144)

Caplan MS10, Polin RA11, Laptook AR12, Keszler M12, Hensman AM12, Basso KM12, Vieira E12, Little E12, Fanaroff AA13, Hibbs AM13, Newman NS13, Truog WE14, Kilbride HW14, Pallotto EK14, Gauldin C14, Holmes A14, Johnson K14, Knutson A14, Schibler K15, Donovan EF15, Alexander B15, Grisby C15, Hessling J15, Fischer EE15, Jackson LD15, Kirker K15, Muthig G15, Goldberg RN16, Cotten CM16, Fisher KA16, Auten KJ16, Foy KA16, Grimes S16, Finkle J16, Laughon MM16, Bose CL16, Bernhardt J16, Bose G16, Carlton DP17, Hale EC17, Archer SW18, Poindexter BB19, Sokol GM19, Wilson LD19, Herron DE19, Sánchez PJ20, Nelin LD20, Jadcherla SR20, Luzader P20, Fortney CA20, Besner GE20, Parikh NA20, Das A21, Wallace D21, Auman JO21, Crawford MM21, Petrie Huitema CM21, Zaterka-Baxter KM21, Van Meurs KP22, Adams MM22, Stevenson DK22, Ball MB22, Palmquist AW22, Proud MS22, Frantz ID 3rd23, Fiascone JM23, MacKinnon BL23, Nylen E23, Carlo WA24, Ambalavanan N24, Collins MV24, Cosby SS24, Devaskar U25, Garg M25, Chanlaw T25, Geller R25, Bell EF26, Ellsbury DL26, Widness JA26, Johnson KJ26, Campbell DB26, Watterberg KL27, Ohls RK27, Lacy CB27, Montman RA27, Brown S27, Wussow T27, Hartenberger C27, Schmidt B28, Kirpalani H28, DeMauro SB28, Chaudhary AS28, Abbasi S28, Mancini T28, Cucinotta DM28, D'Angio CT29, Guillet R29, Lakshminrusimha S29, Reynolds AM29, Reubens LJ29, Jensen R29, Maffett D29, Wadkins HIM29, Sacilowski MG29, Williams A29, Guilford S29, Horihan CA29, Kennedy KA30, Tyson JE30, Burson K30, Harris BF30, McDavid GE30, Pierce Tate PL30, Wright SL30, Sánchez PJ31, Brion LP31, Chen L31, Guzman A31, Leps MH31, Miller NA31, Morgan JS31, Vasil DM31, Torres LE31, Faix RG32, Yoder BA32, Osborne KA32, Bird K32, Burnett J32, Jensen JJ32, Spencer C32, Weaver-Lewis K32, Zanetti K32, Shankaran S33, Barks J33, Bara R33, Johnson M33, Christensen M33, Wiggins S33, Ehrenkranz RA34, Jacobs H34, Cervone P34, Konstantino M34, Poulsen J34, Taft J34.

Author information

1
Division of Neonatology and Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia, PA. Electronic address: jensene@email.chop.edu.
2
Division of Neonatology and Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia, PA.
3
Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC.
4
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
5
Department of Pediatrics, Brown University and Women and Infant's Hospital of Rhode Island, Providence, RI.
6
Department of Pediatrics, The University of North Carolina, Chapel Hill, NC.
7
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
8
University of Texas Health Science Center, McGovern Medical School, Houston, TX.
9
Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH.
10
University of Chicago, Pritzker School of Medicine.
11
Division of Neonatology, College of Physicians and Surgeons, Columbia University.
12
Alpert Medical School of Brown University and Women and Infants Hospital of Rhode Island.
13
Case Western Reserve University, Rainbow Babies and Children's Hospital.
14
Children's Mercy Hospital, University of Missouri Kansas City School of Medicine.
15
Cincinnati Children's Hospital Medical Center, University Hospital, and Good Samaritan Hospital.
16
Duke University School of Medicine, University Hospital, University of North Carolina, and Duke Regional Hospital.
17
Emory University, Children's Healthcare of Atlanta, Grady Memorial Hospital, Emory University Hospital Midtown.
18
Eunice Kennedy Shriver National Institute of Child Health and Human Development.
19
Indiana University, University Hospital, Methodist Hospital, Riley Hospital for Children, and Wishard Health Services.
20
Nationwide Children's Hospital and the Ohio State University Medical Center.
21
RTI International.
22
Stanford University, Dominican Hospital, El Camino Hospital, and Lucile Packard Children's Hospital.
23
Tufts Medical Center, Floating Hospital for Children.
24
University of Alabama at Birmingham Health System and Children's Hospital of Alabama.
25
University of California-Los Angeles, Mattel Children's Hospital, Santa Monica Hospital, Los Robles Hospital and Medical Center, Olive View Medical Center.
26
University of Iowa and Mercy Medical Center.
27
University of New Mexico Health Sciences Center.
28
University of Pennsylvania, Hospital of the University of Pennsylvania, Pennsylvania Hospital, Children's Hospital of Philadelphia.
29
University of Rochester Medical Center, Golisano Children's Hospital, University of Buffalo Women's, Children's Hospital of Buffalo.
30
University of Texas Health Science Center at Houston Medical School, Children's Memorial Hermann Hospital.
31
University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, Children's Medical Center Dallas.
32
University of Utah University Hospital, Intermountain Medical Center, LDS Hospital, Primary Children's Medical Center.
33
Wayne State University, University of Michigan, Hutzel Women's Hospital, Children's Hospital of Michigan.
34
Yale University, Yale-New Haven Children's Hospital, Bridgeport Hospital.

Abstract

OBJECTIVE:

To assess the association between prophylactic indomethacin and bronchopulmonary dysplasia (BPD) in a recent, large cohort of extremely preterm infants.

STUDY DESIGN:

Retrospective cohort study using prospectively collected data for infants with gestational ages < 29 weeks or birth weights of 401-1000 g born between 2008 and 2012 at participating hospitals of the National Institute of Child Health and Human Development Neonatal Research Network. Infants treated with indomethacin in the first 24 hours of life were compared with those who were not. Study outcomes were BPD, defined as use of supplemental oxygen at 36 weeks postmenstrual age among survivors to that time point, death, and the composite of death or BPD. Prespecified subgroup analyses were performed.

RESULTS:

Prophylactic indomethacin use varied by hospital. Treatment of a patent ductus arteriosus after the first day of life was less common among 2587 infants who received prophylactic indomethacin compared with 5244 who did not (21.0% vs 36.1%, P < .001). After adjustment for potential confounders, use of prophylactic indomethacin was not associated with higher or lower odds of BPD (OR 0.89, 95% CI 0.72-1.10), death (OR 0.80, 95% CI 0.64-1.01), or death or BPD (OR 0.87, 95% CI 0.71-1.05). The only evidence of subgroup effects associated with prophylactic indomethacin were lower odds of death among infants with birth weights above the 10th percentile and those who were not treated for a patent ductus arteriosus after the first day of life.

CONCLUSIONS:

Prophylactic indomethacin was not associated with either reduced or increased risk for BPD or death.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT00063063.

KEYWORDS:

bronchopulmonary dysplasia; extreme prematurity; indomethacin; prophylaxis

Comment in

PMID:
28258737
PMCID:
PMC5484725
DOI:
10.1016/j.jpeds.2017.02.003
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center