Association of Co-Exposure of Antenatal Steroid and Prophylactic Indomethacin with Spontaneous Intestinal Perforation.
indomethacin
infant
intestinal perforation
preterm
steroid
Journal
The Journal of pediatrics
ISSN: 1097-6833
Titre abrégé: J Pediatr
Pays: United States
ID NLM: 0375410
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
25
01
2021
revised:
17
02
2021
accepted:
10
03
2021
pubmed:
21
3
2021
medline:
9
11
2021
entrez:
20
3
2021
Statut:
ppublish
Résumé
To evaluate the association of a combined exposure to antenatal steroids and prophylactic indomethacin with the outcome of spontaneous intestinal perforation (SIP) among neonates born at <26 weeks of gestation or <750 g birth weight. We conducted a retrospective study of preterm infants admitted to Canadian Neonatal Network units between 2010 and 2018. Infants were classified into 2 groups based on receipt of antenatal steroids; the latter subgrouped as recent (≤7 days before birth) or latent (>7 days before birth) exposures. The co-exposure was prophylactic indomethacin. The primary outcome was SIP. Multivariable logistic regression analysis was used to calculate aORs. Among 4720 eligible infants, 4121 (87%) received antenatal steroids and 1045 (22.1%) received prophylactic indomethacin. Among infants exposed to antenatal steroids, those who received prophylactic indomethacin had higher odds of SIP (aOR 1.61, 95% CI 1.14-2.28) compared with no prophylactic indomethacin. Subgroup analyses revealed recent antenatal steroids exposure with prophylactic indomethacin had higher odds of SIP (aOR 1.67, 95% CI 1.15-2.43), but latent antenatal steroids exposure with prophylactic indomethacin did not (aOR 1.24, 95% CI 0.48-3.21), compared with the respective groups with no prophylactic indomethacin. Among those not exposed to antenatal steroids, mortality was lower among those who received prophylactic indomethacin (aOR 0.45, 95% CI 0.28-0.73) compared with no prophylactic indomethacin. In preterm neonates of <26 weeks of gestation or birth weight <750 g, co-exposure of antenatal steroids and prophylactic indomethacin was associated with SIP, especially if antenatal steroids was received within 7 days before birth. Among those unexposed to antenatal steroids, prophylactic indomethacin was associated with lower odds of mortality.
Identifiants
pubmed: 33741365
pii: S0022-3476(21)00226-2
doi: 10.1016/j.jpeds.2021.03.012
pii:
doi:
Substances chimiques
Steroids
0
Indomethacin
XXE1CET956
Types de publication
Journal Article
Comment
Langues
eng
Sous-ensembles de citation
IM
Pagination
34-41.e1Investigateurs
Marc Beltempo
(M)
Joseph Ting
(J)
Zenon Cieslak
(Z)
Rebecca Sherlock
(R)
Ayman Abou Mehrem
(AA)
Jennifer Toye
(J)
Khalid Aziz
(K)
Carlos Fajardo
(C)
Jaya Bodani
(J)
Lannae Strueby
(L)
Mary Seshia
(M)
Deepak Louis
(D)
Ruben Alvaro
(R)
Amit Mukerji
(A)
Orlando Da Silva
(O)
Eugene Ng
(E)
Brigitte Lemyre
(B)
Thierry Daboval
(T)
Faiza Khurshid
(F)
Ermelinda Pelausa
(E)
Keith Barrington
(K)
Anie Lapoint
(A)
Guillaume Ethier
(G)
Christine Drolet
(C)
Bruno Piedboeuf
(B)
Martine Claveau
(M)
Marie St-Hilaire
(M)
Valerie Bertelle
(V)
Edith Masse
(E)
Roderick Canning
(R)
Hala Makary
(H)
Cecil Ojah
(C)
Luis Monterrosa
(L)
Julie Emberley
(J)
Jehier Afifi
(J)
Andrzej Kajetanowicz
(A)
Wendy Whittle
(W)
Michelle Morais
(M)
Leanne Dahlgren
(L)
Darine El-Chaar
(D)
Katherine Theriault
(K)
Annie Ouellet
(A)
Kimberly Butt
(K)
Stephen Wood
(S)
Amy Metcalfe
(A)
Candace O'Quinn
(C)
Christy Pylypjuk
(C)
Isabelle Boucoiran
(I)
Catherine Taillefer
(C)
Joan Crane
(J)
Haim Abenhaim
(H)
Graeme Smith
(G)
Karen Wou
(K)
Sue Chandra
(S)
Jagdeep Ubhi
(J)
George Carson
(G)
Michael Helewa
(M)
Ariadna Grigoriu
(A)
Rob Gratton
(R)
James Andrews
(J)
Nir Melamed
(N)
Jason Burrows
(J)
Fatima Taboun
(F)
Lara Wesson
(L)
Erin MacLellan
(E)
Hayley Boss
(H)
Vicky Allen
(V)
Commentaires et corrections
Type : CommentIn
Type : CommentOn
Type : CommentIn
Type : CommentOn
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.