ArticleJournal of perinatology : official journal of the California Perinatal Association2010
Prenatal or postnatal indomethacin exposure and neonatal gut injury associated with isolated intestinal perforation and necrotizing enterocolitis.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Use of NSAIDs and acetaminophen and risk of spontaneous intestinal perforations in premature infants: a systematic review and meta-analysis.Frontiers in pediatrics · 2024Pooled it
- The association between patent ductus arteriosus and adverse outcomes in preterm infants.BMC pediatrics · 2026Article
- Association Between Birth Weight and Severity of Neonatal Jaundice: A Case-Control Study.Cureus · 2025Article
- Promising Preventive Strategies for Intraventricular Hemorrhage in Preterm Neonates: A Critical Review.Journal of clinical medicine · 2025Review
- Association of Intrapartum Drugs with Spontaneous Intestinal Perforation: A Single-Center Retrospective Review.American journal of perinatology · 2024Review
- Risk factors and epidemiology of spontaneous intestinal perforation among infants born at 22-24 weeks' gestational age.Journal of perinatology : official journal of the California Perinatal Association · 2024Observational
- Prophylactic indomethacin, antenatal betamethasone, and the risk of intestinal perforation in infants <28 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2023Observational
- Antenatal Steroids, Prophylactic Indomethacin, and the Risk of Spontaneous Intestinal Perforation.The Journal of pediatrics · 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
- Balancing Benefits and Risks of Indomethacin in the Management of Antenatal Bartter Syndrome: A Case Report.Frontiers in medicine · 2022Article
- Impaired antimicrobial response and mucosal protection induced by ibuprofen in the immature human intestine.Pediatric research · 2018Article
- Clinical implication of spontaneous gastrointestinal perforation in pediatric patients: its difference according to age group.Annals of surgical treatment and research · 2018Article
- Effect of prophylactic indomethacin administration and early feeding on spontaneous intestinal perforation in extremely low-birth-weight infants.Journal of perinatology : official journal of the California Perinatal Association · 2017Article
- Antenatal Magnesium Sulfate, Necrotizing Enterocolitis, and Death among Neonates < 28 Weeks Gestation.AJP reports · 2016Article
- Formula Feeding Predisposes Gut to NSAID-Induced Small Intestinal Injury.Clinical & experimental pharmacology · 2016Article
- Indomethacin for treatment of prolapsed amniotic sac "hourglass membranes" presented at late mid-trimester.Saudi medical journal · 2016Article
- Intestinal perforation in very preterm neonates: risk factors and outcomes.Journal of perinatology : official journal of the California Perinatal Association · 2015Article
- Prophylactic indomethacin and intestinal perforation in extremely low birth weight infants.Pediatrics · 2014Article
- Prevention and early recognition of necrotizing enterocolitis: a tale of 2 tools--eNEC and GutCheckNEC.Advances in neonatal care : official journal of the National Association of Neonatal Nurses · 2014Article
- Necrotizing enterocolitis and focal intestinal perforation in neonatal intensive care units in the state of baden-württemberg, Germany.Pediatric reports · 2014Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the role of indomethacin in neonatal gut injury. STUDY
designInfants born at gestational age 23 weeks and with birth weights 400-1200 g were included in this prospective prevalence study of neonatal gut injury. Infants with isolated intestinal perforation (IIP) confirmed at laparotomy or at autopsy or with necrotizing enterocolitis (NEC) were identified. Data were abstracted bi-weekly.
resultAmong 992 study infants, 58 infants exposed solely to prenatal indomethacin did not show an increased rate of neonatal gut injury. Any postnatal indomethacin exposure (n=611) increased the odds of IIP (OR 4.17, CI, 1.24-14.08, P=0.02) but decreased the odds of NEC (OR 0.65, CI 0.43-0.97, P=0.04). There was a negative association between the timing of indomethacin-exposure and the odds of developing IIP (OR 0.30, CI 0.11-0.83, P=0.02). Compared with NEC, IIP occurred at an earlier age (P<0.05) and was more common (P<0.05) among infants who received early indomethacin (first dose at <12 h of age) to prevent intraventricular hemorrhage than among infants who were treated with late indomethacin for closure of a patent ductus arteriosus (PDA). Unlike the classic hemorrhagic ischemic lesions of NEC in which large areas of tissue were inflamed or necrotic, the IIP lesions were small and discrete.
conclusionEarly (<12 h) postnatal indomethacin exposure was associated with an increased odds of IIP in very low birth weight infants whereas its later use for closure of a PDA appeared to provide protection against NEC. The paradoxical effect of the timing of indomethacin on IIP versus on NEC may be related to the different pathogeneses of the two diseases. Our findings also suggest that PDA may contribute to NEC.
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