29 周以下早产儿单剂量预防性使用吲哚美辛的结局。
Outcomes in infants < 29 weeks of gestation following single-dose prophylactic indomethacin.
机构信息
Mildred T. Stahlman Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
J Perinatol. 2021 Jan;41(1):109-118. doi: 10.1038/s41372-020-00814-9. Epub 2020 Sep 18.
BACKGROUND
Prophylactic indomethacin (3 doses) decreases patent ductus arteriosus (PDA) and intraventricular hemorrhage (IVH) in preterm infants. The study aim was to determine whether single-dose indomethacin (SD-INDO) decreases PDA, IVH, and improves motor function.
METHODS
A retrospective cohort (2007-2014) compared infants born < 29 weeks who did (n = 299) or did not (n = 85) receive SD-INDO and estimated outcomes association with ordinal logistic regression, adjusting for multiple variables using propensity scores.
RESULTS
Infants who received SD-INDO were more premature (p < 0.001) but had lower odds of PDA (OR 0.26 [0.15, 0.44], p < 0.005), PDA receiving treatment (OR 0.12 [0.03, 0.47], p < 0.005), death (OR 0.41 [0.20, 0.86], p = 0.02), and CP severity (OR 0.33 [0.12, 0.89], p = 0.03). There was less IVH (OR 0.58 [0.36, 0.94], p = 0.03) when adjusted for gestational age.
CONCLUSIONS
SD-INDO is associated with decreased PDA and CP severity and improved survival.
背景
预防性使用吲哚美辛（3 剂）可减少早产儿动脉导管未闭（PDA）和脑室出血（IVH）。本研究旨在确定单剂量吲哚美辛（SD-INDO）是否可减少 PDA、IVH，并改善运动功能。
方法
回顾性队列研究（2007-2014 年）比较了接受（n=299）或未接受（n=85）SD-INDO 的<29 周出生的婴儿，并使用倾向评分调整多个变量的有序逻辑回归估计结局的相关性。
结果
接受 SD-INDO 的婴儿更早产（p<0.001），但 PDA 的可能性较低（OR 0.26[0.15,0.44]，p<0.005），需要接受 PDA 治疗的可能性较低（OR 0.12[0.03,0.47]，p<0.005），死亡率（OR 0.41[0.20,0.86]，p=0.02）和脑瘫严重程度（OR 0.33[0.12,0.89]，p=0.03）较低。调整胎龄后，IVH 发生率较低（OR 0.58[0.36,0.94]，p=0.03）。
结论
SD-INDO 与减少 PDA 和脑瘫严重程度以及提高生存率有关。
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