Outcomes of Prophylactic lndomethacin for Extremely Low Birth Weight Infants

Background: Prophylactic indomethacin (PI) administered to preterm infants has been shown to decrease severe intraventricular haemorrhage (IVH) and the need for surgical ligation of patent ductus arteriosus (PDA). The aim of this study was to compare the short-term and long-term outcomes of a PI-treated group (Indo group) with a recent retrospective, historical cohort (control group). Methods: We performed a retrospective review of 85 infants, 40 iodomethacin-treated and 45 untreated controls, born <= 28 weeks' gestation and weighing <1000 g. Short-term outcomes and neurodevelopmental outcomes at 24 months of corrected age were compared between the two groups. Results: Severe IVH was less in the Indo group (7.5%) than in the control group (13.3%), but this difference did not reach statistical difference (P=0.38). The occurrence of significant PDA was significantly lower in the Indo group (30%) compared to the control group (51%) (P=0.04). Patients who received PI experienced a decreased PDA surgical ligation rate (control group = 35.6%, Indo group = 12%; P=0.01). This statistical difference persisted even after logistic regression analysis (P=0.04). At 2 years, no significant differences were found between the groups in terms of Mental development index and the psychomotor development index scores <70, the incidence of cerebral palsy, neurodevelopmental impairment, or composite outcomes. Conclusion: PI decreased surgical PDA in preterm infants. However, PI did not cause an improvement in neurodevelopmental outcomes once these children reached 2 years. PDA may play a limited role in the multifactorial factors in the causation of neurodevelopmental impairment of preterm infants.