Indomethacin for intraventricular hemorrhage prophylaxis in preterm neonates, a retrospective cohort study
Keywords:
Preterm infants, Intraventricular hemorrhage, Indomethacin, Necrotizing EnterocolitisAbstract
Background: Intraventricular hemorrhage (IVH) is a common condition in preterm infants, particularly those with low gestational age (GA) and low birth weight. Severe IVH (SIVH) increases mortality rates and developmental delays in surviving infants. Indomethacin can reduce the incidence of IVH in neonates.
Objective: To study the outcomes and side effects of indomethacin in preventing IVH.
Methods: A retrospective study was conducted at Khon Kaen Hospital from July 2020 to June 2024. Neonates with a birthweight below 1,251 grams and had results of ultrasound brain screening for IVH were included.
Results: The study included 148 infants with a mean GA of 28 ± 3 weeks (range 24–35 weeks) and a mean birthweight of 995 ± 189 grams (range 490–1,250 grams); 51.4% were male. Indomethacin was administered to 25/148 (16.9%) infants. The rate of IVH was not significant different between the indomethacin-treated group and the non-treated group, 52% versus 49.6%, respectively. However, the treatment group tended to have a lower rate of SIVH compared to the non-treated group, 12% versus 18.7%, respectively, but not statistically significant. Indomethacin increased the risk of necrotizing enterocolitis (NEC) stage 2 or more (p value 0.05).
Conclusion: Infants with a birthweight below 1,251 grams who received indomethacin for IVH prophylaxis had a lower incidence of SIVH but might carry a higher risk of NEC stage 2 or more compared to non-treated group.
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