Evidence map›Paper›PMID 29907397›Full record

SynthesisSeminars in perinatology2018

Association between prophylactic indomethacin and death or bronchopulmonary dysplasia: A systematic review and meta-analysis of observational studies.

Erik A Jensen, Elizabeth E Foglia, Barbara Schmidt

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Seminars in perinatology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Observational
  5. Article
  6. Effects of prophylactic indomethacin on intraventricular hemorrhage and adverse outcomes in neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2022
    Article
  7. Review
  8. Review
  9. Online clinical tool to estimate risk of bronchopulmonary dysplasia in extremely preterm infants.Archives of disease in childhood. Fetal and neonatal edition · 2022
    Article
  10. Outcomes in infants < 29 weeks of gestation following single-dose prophylactic indomethacin.Journal of perinatology : official journal of the California Perinatal Association · 2021
    Article
  11. Review
  12. Article
  13. Review
  14. Review
  15. Review
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Erik A JensenDivision of Neonatology and Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania. Electronic address: jensene@email.chop.edu.
Elizabeth E FogliaDivision of Neonatology and Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania.
Barbara SchmidtDivision of Neonatology and Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania.

Funding

Microbiome of the Airway and the Risk for Bronchopulmonary Dysplasia in the Lungs of Extreme Preterms: The MARBLE StudyK23HL136843 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI JENSEN, ERIK ALLEN · 2018 to 2022
$819k
Optimizing Respiratory Function in Delivery Room Resuscitation: The INFLATE Study (INFant Lung Aeration during Transition Events)K23HD084727 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI FOGLIA, ELIZABETH · 2016 to 2020
$809k
NHLBI NIH HHS K23 HL136843NICHD NIH HHS K23 HD084727
6 · The paper itself

Abstract

The use of prophylactic indomethacin in very preterm infants is controversial. The last randomized controlled trial (RCT) to study this therapy enrolled infants over 20 years ago. More recently, observational studies have investigated the association between exposure to prophylactic indomethacin and neonatal morbidities and mortality. We performed a systematic review and meta-analysis of these studies for the outcomes of death and bronchopulmonary dysplasia (BPD). Two observational studies involving a total of 11,289 very preterm infants were suitable for meta-analysis. The pooled data showed that prophylactic indomethacin was not associated with higher or lower risk-adjusted odds of death or BPD (0.93, 95% CI: 0.76-1.13) and of BPD among survivors (0.94, 95% CI: 0.78-1.12). However, there was a weak association between indomethacin prophylaxis and decreased risk-adjusted odds of mortality (0.81, 95% CI: 0.66-0.98). It is unknown whether this finding resulted from unmeasured confounding, chance, or represents a true benefit. To confirm the hypothesis that prophylactic indomethacin has a small effect on mortality in the current era, a contemporary RCT would need to enroll over 3500 very immature infants at high risk of death.

Indexed as

Infant, Extremely PrematureAge FactorsAnti-Inflammatory Agents, Non-SteroidalBronchopulmonary DysplasiaDuctus Arteriosus, PatentHumansIndomethacinInfant, NewbornObservational Studies as TopicTreatment OutcomeAnti-Inflammatory Agents, Non-SteroidalIndomethacinBronchopulmonary dysplasiaMeta-analysisPatent ductus arteriosusPremature infantProphylactic indomethacin

Identifiers

PMID29907397
PMCPMC6072270

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.