PEDIATRICS Vol. 82 No. 4 October 1988, pp. 533-542
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bandstra, E. S.
Right arrow Articles by Bancalari, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bandstra, E. S.
Right arrow Articles by Bancalari, E.

Prophylactic Indomethacin for Prevention of Intraventricular Hemorrhage in Premature Infants

Emmalee Setzer Bandstra MD1, Berta M. Montalvo MD1, Ronald N. Goldberg MD1, Irma Pacheco MD1, Pedro L. Ferrer MD1, John Flynn MD1, Jocelyn B. Gregorios MD1, and Eduardo Bancalari MD1

1 From the Departments of Pediatrics (Divisions of Neonatology and Cardiology, Radiology, Ophthalmology, and Pathology of the University of Miami School of Medicine, Miami

The impact of early prophylactic use of intravenous indomethacin on the incidence and severity of periventricular-intraventricular hemorrhage and patent ductus arteriosus in 199 oxygen-requiring premature infants (le1300 g birth weight) was prospectively investigated. The trial was controlled, the infants were randomized, and the investigators were unaware of the group assignments. Patients with minimal (grade I) or no periventricular-intraventricular hemorrhage determined by prestudy echoencephalography were randomized within two birth weight subgroups (500 to 899 and 900 to 1300 g) to receive either prophylactic indomethacin (n = 99) or an equal volume of saline-vehicle placebo (n = 100). The first dose (0.2 mg/kg) was given within 12 hours of delivery and two subsequent doses (0.1 mg/kg) were administered at 12 hourly intervals. Prophylactic indomethacin significantly reduced the incidence of grades II to IV periventricular-intraventricular hemorrhage. Intraventricular hemorrhage was half as common in infants given prophylactic indomethacin as in control infants (23% v 46%, P < .002). The reduction was manifested in both birth weight subgroups. Results of this study also confirmed a lower incidence of clinically significant patent ductus arteriosus in infants who received prophylactic indomethacin in contrast to those who received placebo (11% v 42%, P < .001). No significant differences were found between treatment and control groups in the duration of oxygen therapy, mechanical ventilation, or hospitalization or in the incidence of pneumothorax, chronic lung disease, sepsis, necrotizing enterocolitis, retinopathy of prematurity, or death. Early prophylactic indomethacin initiated within 12 hours of delivery is effective in reducing the incidence of intraventricular hemorrhage as well as clinically significant patent ductus arteriosus in very low birth weight premature infants.

Key Words: indomethacin • intraventricular hemorrhage • premature infant • patent ductus arteriosus

Submitted on December 30, 1987
Accepted on March 8, 1988




This article has been cited by other articles:


Home page
 J Trop PediatrHome page
J. Liu, Q. Wang, J.-h. Zhao, Y.-h. Chen, and G.-l. Qin
The Combined Antenatal Corticosteroids and Vitamin K Therapy for Preventing Periventricular-Intraventricular Hemorrhage in Premature Newborns less than 35 weeks Gestation
J Trop Pediatr, October 1, 2006; 52(5): 355 - 359.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
L. R. Ment, B. S. Peterson, J. A. Meltzer, B. Vohr, W. Allan, K. H. Katz, C. Lacadie, K. C. Schneider, C. C. Duncan, R. W. Makuch, et al.
A Functional Magnetic Resonance Imaging Study of the Long-term Influences of Early Indomethacin Exposure on Language Processing in the Brains of Prematurely Born Children
Pediatrics, September 1, 2006; 118(3): 961 - 970.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
D. W. Brown, D. Lee, V. S. Kumaran, and T.-Y. Lee
Age-dependent cerebral hemodynamic effects of indomethacin in the newborn piglet
J Appl Physiol, November 1, 2004; 97(5): 1880 - 1887.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
P W Fowlie and P G Davis
Prophylactic indomethacin for preterm infants: a systematic review and meta-analysis
Arch. Dis. Child. Fetal Neonatal Ed., November 1, 2003; 88(6): F464 - 466.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
J. Hitti, P. Tarczy-Hornoch, J. Murphy, S. L. Hillier, J. Aura, and D. A. Eschenbach
Amniotic Fluid Infection, Cytokines, and Adverse Outcome Among Infants at 34 Weeks' Gestation or Less
Obstet. Gynecol., December 1, 2001; 98(6): 1080 - 1088.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P. Monagle, A. D. Michelson, E. Bovill, and M. Andrew
Antithrombotic Therapy in Children
Chest, January 1, 2001; 119(1_suppl): 344S - 370S.
[Full Text] [PDF]

Home page
 PediatricsHome page
L. R. Ment, B. Vohr, W. Allan, M. Westerveld, S. S. Sparrow, K. C. Schneider, K. H. Katz, C. C. Duncan, and R. W. Makuch
Outcome of Children in the Indomethacin Intraventricular Hemorrhage Prevention Trial
Pediatrics, March 1, 2000; 105(3): 485 - 491.
[Abstract] [Full Text]

Home page
 NEJMHome page
M. E. Norton, J. Merrill, B. Cooper, J. A. Kuller, and R. I. Clyman
Neonatal Complications after the Administration of Indomethacin for Preterm Labor
N. Engl. J. Med., November 25, 1993; 329(22): 1602 - 1607.
[Abstract] [Full Text]

Home page
 J Child NeurolHome page
V. S. Miller
Topical Review Article: Pharmacologic Management of Neonatal Cerebral Ischemia and Hemorrhage: Old and New Directions
J Child Neurol, January 1, 1993; 8(1): 7 - 18.
[Abstract] [PDF]

Home page
 J Child NeurolHome page
K. C.K. Kuban, A. Leviton, M. Pagano, T. Fenton, R. Strassfeld, and M. Wolff
Maternal Toxemia Is Associated With Reduced Incidence of Germinal Matrix Hemorrhage in Premature Babies
J Child Neurol, January 1, 1992; 7(1): 70 - 76.
[Abstract] [PDF]

Home page
 J Child NeurolHome page
W. C. Allan
Intraventricular Hemorrhage
J Child Neurol, January 1, 1989; 4(1_suppl): S12 - S22.
[Abstract] [PDF]