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Indomethacin tocolysis and intraventricular hemorrhage

Authors: Barbara V. Parilla; Raymond D Suarez; William A. Grobman;

Indomethacin tocolysis and intraventricular hemorrhage

Abstract

To determine the association between indomethacin tocolysis and neonatal intraventricular hemorrhage.Fifty-six preterm neonates with intraventricular hemorrhage were matched by gestational age with neonates (n = 224) without this morbidity. Maternal and neonatal charts were reviewed to ascertain the type of tocolytic exposure experienced by the neonate. Other maternal and neonatal demographic and outcome data were also abstracted. Results were analyzed using the Student t test, chi(2) analysis, and multivariable logistic regression. The number of studied subjects provided 80% power to determine if antenatal exposure to indomethacin was twice as likely among infants with intraventricular hemorrhage.Univariate analysis revealed that there were no significant differences between the study and control groups with respect to maternal age, parity, or betamethasone exposure. Infants with intraventricular hemorrhage were significantly more likely to be born at an earlier gestational age, a lower birth weight, after maternal chorioamnionitis, after vaginal delivery, and after exposure to either indomethacin alone or a combination of indomethacin and magnesium. Additionally, their neonatal course was significantly more likely to be complicated by sepsis and respiratory distress syndrome. In a multivariable logistic model, only gestational age, chorioamnionitis, vaginal delivery, and respiratory distress syndrome continued to be significantly associated with intraventricular hemorrhage. Indomethacin exposure, either as single-agent (adjusted odds ratio 1.3, 95% confidence interval 0.5, 3.3) or combination tocolytic therapy (adjusted odds ratio 2.0, 95% confidence interval 0.8, 4.8), was not significantly associated with intraventricular hemorrhage.Indomethacin tocolysis is not associated with an increased risk of intraventricular hemorrhage.

Keywords

Adult, Analysis of Variance, Incidence, Anti-Inflammatory Agents, Non-Steroidal, Indomethacin, Infant, Newborn, Pregnancy Outcome, Prognosis, Logistic Models, Obstetric Labor, Premature, Pregnancy, Case-Control Studies, Confidence Intervals, Odds Ratio, Humans, Drug Therapy, Combination, Female, Magnesium, Intracranial Hemorrhages, Probability

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    32
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    Average
    influence
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    Top 10%
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Found an issue? Give us feedback
citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
32
Average
Top 10%
Top 10%
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