Model for severe intracranial hemorrhage and role of early indomethacin in extreme preterm infants

Sanjay Chawla; Girija Natarajan; Abbot R Laptook; Dhuly Chowdhury; Edward F Bell; Namasivayam Ambalavanan; Waldemar A Carlo; Marie Gantz; Abhik Das; Jose L Tapia; Heidi M Harmon; Seetha Shankaran; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1038/s41390-022-02012-z

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Model for severe intracranial hemorrhage and role of early indomethacin in extreme preterm infants

Journal article

Open access

Peer reviewed

Model for severe intracranial hemorrhage and role of early indomethacin in extreme preterm infants

Sanjay Chawla, Girija Natarajan, Abbot R Laptook, Dhuly Chowdhury, Edward F Bell, Namasivayam Ambalavanan, Waldemar A Carlo, Marie Gantz, Abhik Das, Jose L Tapia, …

Pediatric research, Vol.92(6), pp.1648-1656

12/2022

DOI: 10.1038/s41390-022-02012-z

PMCID: PMC9481746

PMID: 35301420

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https://www.ncbi.nlm.nih.gov/pmc/articles/9481746View

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Abstract

To develop a model for prediction of severe intracranial hemorrhage (ICH) or death based on variables from the first 12 h of age and to compare mortality and morbidities with and without exposure to early indomethacin. This retrospective cohort study included extreme preterm (22 -26 weeks) infants born at National Institute of Child Health and Human Development Neonatal Research Network sites. Primary outcome was a composite of severe ICH and/or death. Of 4624 infants, 1827 received early indomethacin. Lower gestation, lack of antenatal steroids exposure, lower 1-min Apgar, male sex, and receipt of epinephrine were associated with severe ICH or death. Early indomethacin was associated with a lower risk of patent ductus arteriosus, bronchopulmonary dysplasia, and higher risk of spontaneous intestinal perforation. A model for early prediction of severe ICH/death was developed and validated. Early indomethacin was associated with a lower risk of patent ductus arteriosus and bronchopulmonary dysplasia and a higher risk of spontaneous intestinal perforation. Not applicable. Modern data on severe ICH and neonatal morbidities in relation to prophylactic indomethacin are scarce in the published literature. Prophylactic indomethacin was associated with a lower risk of patent ductus arteriosus and bronchopulmonary dysplasia and a higher risk of intestinal perforation. A risk estimator for severe intracranial hemorrhage/death was developed in a large cohort of extremely preterm infants. The risk estimator developed based on a large cohort of patients provides an estimate of severe intracranial bleeding for an individual infant.

Bronchopulmonary Dysplasia - prevention & control

Child

Ductus Arteriosus, Patent - complications

Ductus Arteriosus, Patent - drug therapy

Female

Humans

Indomethacin - adverse effects

Infant

Infant, Extremely Premature

Infant, Newborn

Intestinal Perforation

Intracranial Hemorrhages

Male

Pregnancy

Retrospective Studies

Details

Title: Subtitle: Model for severe intracranial hemorrhage and role of early indomethacin in extreme preterm infants
Creators: Sanjay Chawla - Wayne State University
Girija Natarajan - Wayne State University
Abbot R Laptook - Women & Infants Hospital of Rhode Island
Dhuly Chowdhury - RTI International
Edward F Bell - University of Iowa
Namasivayam Ambalavanan - University of Alabama at Birmingham
Waldemar A Carlo - University of Alabama at Birmingham
Marie Gantz - RTI International
Abhik Das - RTI International
Jose L Tapia - Pontificia Universidad Católica de Chile
Heidi M Harmon - University of Iowa
Seetha Shankaran - Wayne State University
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Resource Type: Journal article
Publication Details: Pediatric research, Vol.92(6), pp.1648-1656
DOI: 10.1038/s41390-022-02012-z
PMID: 35301420
PMCID: PMC9481746
NLM abbreviation: Pediatr Res
ISSN: 0031-3998
eISSN: 1530-0447
Grant note: UG1 HD053089 / NICHD NIH HHS U10 HD053109 / NICHD NIH HHS U10 HD027856 / NICHD NIH HHS U10 HD027880 / NICHD NIH HHS U10 HD027853 / NICHD NIH HHS U10 HD021364 / NICHD NIH HHS U10 HD068284 / NICHD NIH HHS U10 HD068278 / NICHD NIH HHS U10 HD027851 / NICHD NIH HHS UG1 HD087229 / NICHD NIH HHS U10 HD034216 / NICHD NIH HHS U10 HD021373 / NICHD NIH HHS U10 HD040492 / NICHD NIH HHS U01 HD036790 / NICHD NIH HHS U10 HD068244 / NICHD NIH HHS U10 HD021385 / NICHD NIH HHS U10 HD068263 / NICHD NIH HHS U10 HD068270 / NICHD NIH HHS U10 HD040689 / NICHD NIH HHS U10 HD027904 / NICHD NIH HHS
Language: English
Date published: 12/2022
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984354152502771

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