Abbasi Soraya, Gerdes Jeffrey S, Sehdev Harish M, Samimi Sara S, Ludmir Jack
Section of Newborn Pediatrics and Maternal-Fetal Medicine, Pennsylvania Hospital, Departments of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia 19107, USA.
Am J Obstet Gynecol. 2003 Sep;189(3):782-5. doi: 10.1067/s0002-9378(03)00662-8.
This study was undertaken to determine the clinical outcome for neonates who were exposed to indomethacin during gestation.
We identified 124 infants with in utero exposure to indomethacin and matched them to 124 infants whose mothers did not receive indomethacin. The two groups were matched for gestational age at birth, sex, and exposure to antenatal betamethasone. Sixty-two of the indomethacin-exposed infants were born within 48 hours of last exposure. These infants were also compared with their matched controls.
There were no significant differences between the indomethacin-exposed infants and control infants in birth weight, Apgar scores, frequency of cesarean section deliveries, and multiple gestation. The incidence of respiratory distress syndrome, need for surfactant treatment, patent ductus arteriosus, necrotizing enterocolitis, and intraventricular hemorrhage was similar between the indomethacin-exposed group and the control group. Indomethacin-exposed infants who were born within 48 hours of last exposure had similar incidence of respiratory distress syndrome but greater need for surfactant treatment (P=.02) compared with controls. All other complication rates were similar.
Indomethacin exposure in our study was not associated with increased neonatal complications for infants delivered within or beyond 48 hours of last exposure.
本研究旨在确定孕期接触吲哚美辛的新生儿的临床结局。
我们确定了124例宫内接触吲哚美辛的婴儿,并将他们与124例母亲未接受吲哚美辛治疗的婴儿进行匹配。两组在出生时的孕周、性别和产前倍他米松暴露情况方面进行了匹配。62例接触吲哚美辛的婴儿在最后一次暴露后48小时内出生。这些婴儿也与其匹配的对照组进行了比较。
接触吲哚美辛的婴儿与对照婴儿在出生体重、阿氏评分、剖宫产分娩频率和多胎妊娠方面无显著差异。接触吲哚美辛组和对照组在呼吸窘迫综合征、表面活性剂治疗需求、动脉导管未闭、坏死性小肠结肠炎和脑室内出血的发生率方面相似。与对照组相比,在最后一次暴露后48小时内出生的接触吲哚美辛的婴儿呼吸窘迫综合征发生率相似,但表面活性剂治疗需求更大(P = 0.02)。所有其他并发症发生率相似。
在我们的研究中,最后一次暴露后48小时内或超过48小时分娩的婴儿,接触吲哚美辛与新生儿并发症增加无关。