NDLI: Spontaneous intestinal perforation in extremely low birth weight infants: association with indometacin therapy and effects on neurodevelopmental outcomes at 18-22 months corrected age.

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Spontaneous intestinal perforation in extremely low birth weight infants: association with indometacin therapy and effects on neurodevelopmental outcomes at 18-22 months corrected age.

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Spontaneous intestinal perforation in extremely low birth weight infants: association with indometacin therapy and effects on neurodevelopmental outcomes at 18-22 months corrected age.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Wadhawan, Rajan Oh, William Vohr, Betty R. Saha, Shampa Das, Abhik Bell, Edward F. Laptook, Abbott Shankaran, Seetha Stoll, Barbara J. Walsh, Michele C. Higgins, Rose
Description	Country affiliation: United States Author Affiliation: Wadhawan R ( Division of Neonatology, All Children's Hospital, St Petersburg, Florida, USA. Rajan.Wadhawan.MD@flhosp.org)
Abstract	BACKGROUND: Spontaneous intestinal perforation (SIP) is associated with the use of postnatal glucocorticoids and indometacin in extremely low birth weight (ELBW) infants. The authors hypothesised: 1) an association of SIP with the use of antenatal steroids (ANS) and indometacin either as prophylaxis for intraventricular hemorrhage (IVH) (P Indo) or for treatment of PDA (Indo/PDA) and 2) an increased risk of death or abnormal neurodevelopmental outcomes in infants with SIP at 18-22 months corrected age. DESIGN/METHODS: The authors retrospectively identified ELBW infants with SIP in the Neonatal Research Network's generic database. Unadjusted analysis identified the differences in maternal, neonatal and clinical variables between infants with and without SIP. Logistic regression analysis identified the adjusted OR for SIP with reference to ANS, P Indo and Indo/PDA. Neurodevelopmental outcomes were assessed among survivors at 18-22 months corrected age. RESULTS: Indo/PDA was associated with an increased risk of SIP (adjusted OR 1.61; 95% CI 1.25 to 2.08), while P Indo and ANS were not. SIP was independently associated with an increased risk of death or neurodevelopmental impairment (NDI) (adjusted OR 1.85; 95% CI 1.32 to 2.60) and NDI among survivors (adjusted OR 1.75, 95% CI 1.20 to 2.55). CONCLUSION: Indometacin used for IVH prophylaxis and ANS were not associated with the occurrence of SIP in ELBW infants. Indometacin used for treatment of symptomatic PDA was however associated with an increased risk of SIP. ELBW infants with SIP have an increased risk of poor neurodevelopmental outcomes.
File Format	HTM / HTML
ISSN	13592998
e-ISSN	14682052
DOI	10.1136/archdischild-2011-300659
Journal	Archives of Disease in Childhood - Fetal and Neonatal Edition
Issue Number	2
Volume Number	98
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2013-03-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Pediatrics Discipline Perinatology Anti-inflammatory Agents, Non-steroidal Adverse Effects Indomethacin Infant, Extremely Low Birth Weight Infant, Premature, Diseases Drug Therapy Intestinal Perforation Chemically Induced Therapeutic Use Developmental Disabilities Ductus Arteriosus, Patent Infant, Extremely Premature Infant, Newborn Infant, Premature Intracranial Hemorrhages Prevention & Control Retrospective Studies Research Support, N.i.h., Extramural
Content Type	Text
Resource Type	Article
Subject	Pediatrics, Perinatology and Child Health Obstetrics and Gynecology

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