Butler-O'Hara Meggan, D'Angio Carl T
Department of Pediatrics, Division of Neonatology, University of Rochester, Rochester, NY, USA.
J Perinatol. 2002 Oct-Nov;22(7):541-6. doi: 10.1038/sj.jp.7210790.
To determine the risk of persistent renal insufficiency (RI) in premature infants following the use of antenatal indomethacin for suppression of preterm labor.
This population-based, retrospective review consisted of infants admitted during a 5-year period (1994-1999) to a tertiary referral neonatal intensive care nursery. Data were reviewed on 37 infants whose mothers received indomethacin for tocolysis, and on 37 matched controls. Renal insufficiency was defined as infant creatinine (Cr) > or = 1.5 mg/dl (133 micromol/l) for > or = 1 day.
Infants whose mothers had received indomethacin for tocolysis were more likely than matched controls to have RI (9 of 37 vs 2 of 37, p = 0.04). Among infants of indomethacin-treated mothers with elevated Cr, serum Cr remained > or = 1.5 mg/dl (133 micromol/l) for a median of 6 days and > 1.0 mg/dl (88 micromol/l) for a median of 19 days. The peak Cr and length of elevation were closely correlated (r(2) = 0.63, p < 0.0001).
Antenatal indomethacin can result in significant, prolonged RI in the infant. It may pose important risks to renal function and homeostasis in premature infants.
确定产前使用吲哚美辛抑制早产的早产儿持续性肾功能不全（RI）的风险。
这项基于人群的回顾性研究包括1994年至1999年期间入住三级转诊新生儿重症监护病房的婴儿。对37名母亲接受吲哚美辛进行安胎治疗的婴儿以及37名匹配对照的资料进行了回顾。肾功能不全定义为婴儿肌酐（Cr）≥1.5mg/dl（133μmol/l）持续≥1天。
母亲接受吲哚美辛安胎治疗的婴儿比匹配对照更易发生肾功能不全（37例中有9例，而37例对照中有2例，p = 0.04）。在母亲接受吲哚美辛治疗且肌酐升高的婴儿中，血清肌酐≥1.5mg/dl（133μmol/l）的中位数为6天，≥1.0mg/dl（88μmol/l）的中位数为19天。肌酐峰值与升高持续时间密切相关（r² = 0.63，p < 0.0001）。
产前使用吲哚美辛可导致婴儿出现显著且持续时间长的肾功能不全。它可能给早产儿的肾功能和内环境稳定带来重要风险。
