ArticleJournal of perinatology : official journal of the California Perinatal Association
Neonatal necrotizing enterocolitis with intestinal perforation in extremely premature infants receiving early indomethacin treatment for patent ductus arteriosus.
Article in Journal of perinatology : official journal of the California Perinatal Association. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Indomethacin for symptomatic patent ductus arteriosus in preterm infants.The Cochrane database of systematic reviews · 2021Pooled it
- A meta-analysis of ibuprofen versus indomethacin for closure of patent ductus arteriosus.European journal of pediatrics · 2005Pooled it
- Nutrition of the preterm infant with persistent ductus arteriosus: existing evidence and practical implications.Pediatric research · 2026Review
- Clinical Impact of the PDA and Its Management on Outcomes of Preterm Infants with NEC: A Review.American journal of perinatology · 2026Review
- Efficacy of paracetamol in the management of hemodynamically significant patent ductus arteriosus in preterm newborns.Indian journal of pharmacology · 2024Article
- Clinical Dilemma Involving Treatments for Very Low-Birth-Weight Infants and the Potential Risk of Necrotizing Enterocolitis: A Narrative Literature Review.Journal of clinical medicine · 2023Review
- The severity of NEC is ameliorated by prostaglandin E2 through regulating intestinal microcirculation.Scientific reports · 2023Article
- Acetaminophen versus indomethacin for patent ductus arteriosus management in premature infants: systematic review and meta-analysis of randomized controlled trials.Paediatrics & child health · 2023Article
- Patent ductus arteriosus and spontaneous intestinal perforation in a cohort of preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- The Association of Patent Ductus Arteriosus with Inflammation: A Narrative Review of the Role of Inflammatory Biomarkers and Treatment Strategy in Premature Infants.International journal of molecular sciences · 2022Review
- A role for abdominal ultrasound in discriminating suspected necrotizing enterocolitis in congenital heart disease patients.Pediatric surgery international · 2022Article
- The pattern of neonatal gastro-intestinal perforation in upper Egypt.Annals of pediatric surgery · 2020Article
- Impaired antimicrobial response and mucosal protection induced by ibuprofen in the immature human intestine.Pediatric research · 2018Article
- A quality improvement initiative to reduce necrotizing enterocolitis across hospital systems.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
- Splanchnic NIRS monitoring in neonatal care: rationale, current applications and future perspectives.Journal of perinatology : official journal of the California Perinatal Association · 2018Review
- Formula Feeding Predisposes Gut to NSAID-Induced Small Intestinal Injury.Clinical & experimental pharmacology · 2016Article
- Prophylactic indomethacin and intestinal perforation in extremely low birth weight infants.Pediatrics · 2014Article
- Efficacy of paracetamol for the treatment of patent ductus arteriosus in preterm neonates.Italian journal of pediatrics · 2014Article
- Evidence-based use of indomethacin and ibuprofen in the neonatal intensive care unit.Clinics in perinatology · 2012Review
- What really causes necrotising enterocolitis?ISRN gastroenterology · 2012Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Survival of extremely premature infants (< 27 weeks' gestational age) has improved over the past two decades. Indomethacin prophylaxis was used in these infants, who have the highest mortality and morbidity rates, to reduce the incidence of intraventricular hemorrhage and patent ductus arteriosus (PDA). Medical records of 65 extremely premature infants born at our institution between 1995 and 2001 were reviewed retrospectively to determine whether treatment of PDA with indomethacin in the first 48 hours of life reduces the need for PDA ligation or increases neonatal morbidity, when compared to treatment begun later. Thirty infants in the early treatment group (ETG) were treated during the first 48 hours after birth, and 32 infants in the standard treatment group (STG) were managed expectantly for PDA. Three infants died in the first hours of life and were eliminated from further analysis. ETG infants were 24.9 +/- 1.1 (mean +/- SD) weeks' gestation with a birth weight of 678 +/- 143 g. STG infants were 25.3 +/- 1.1 weeks (NS) and 730 +/- 125 g (NS). Hemodynamically significant PDA was diagnosed or confirmed by echocardiography in 19 ETG patients and 17 STG patients. Of the patients with hemodynamically significant PDA, 1 (5%) ETG patient and 6 (35%) STG patients underwent surgical ligation (p = 0.033). Necrotizing enterocolitis (NEC) with intestinal perforation was the most serious morbidity and occurred in 20% of infants in the ETG, but in no STG infant (p = 0.011). Four of the six infants in the ETG with NEC and intestinal perforation died. The overall mortality rate for all infants studied was 28%. We conclude that in extremely premature infants, use of indomethacin during the first 48 hours of life was associated with a reduced need for PDA ligation, but an increased risk of NEC with intestinal perforation.
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