Qureshi, M., Shah, P. S., Abdelgadir, D., Ye, X. Y., Afifi, J., Yuen, R., Crossman, S. C., Taylor, B., Mohammad, K., Piedboeuf, B., Aziz, K., Beltempo, M., Kanungo, J., Ting, J., Cieslak, Z., Sherlock, R., Mehrem, A. A., Toye, J., Fajardo, C., ... Lee, S. K. (2021). Gestational Age-Dependent Variations in Effects of Prophylactic Indomethacin on Brain Injury and Intestinal Injury. Journal of Pediatrics, 235, 26-33.e2. https://doi.org/10.1016/j.jpeds.2021.02.073
Qureshi, M, Shah, PS, Abdelgadir, D, Ye, XY, Afifi, J, Yuen, R, Crossman, SC, Taylor, B, Mohammad, K, Piedboeuf, B, Aziz, K, Beltempo, M, Kanungo, J, Ting, J, Cieslak, Z, Sherlock, R, Mehrem, AA, Toye, J, Fajardo, C, Kalapesi, Z, Bodani, J, Sankaran, K, Strueby, L, Seshia, M, Louis, D, Alvaro, R, Mukerji, A, Da Silva, O, Adie, M, Lee, KS, Ng, E, Lemyre, B, Khurshid, F, Pelausa, E, Barrington, K, Lapoint, A, Ethier, G, Drolet, C, Claveau, M, Bertelle, V, Masse, E, Canning, R, Makary, H, Ojah, C, Monterrosa, L, Emberley, J, Kajetanowicz, A & Lee, SK 2021, 'Gestational Age-Dependent Variations in Effects of Prophylactic Indomethacin on Brain Injury and Intestinal Injury', Journal of Pediatrics, vol. 235, pp. 26-33.e2. https://doi.org/10.1016/j.jpeds.2021.02.073
@article{b926b2342c164d948265028c83e10152,
title = "Gestational Age-Dependent Variations in Effects of Prophylactic Indomethacin on Brain Injury and Intestinal Injury",
abstract = "Objective: To evaluate the impact of prophylactic indomethacin on early death (<10 days after birth) or severe neurologic injury and on early death or spontaneous intestinal perforation by completed weeks of gestational age in neonates born <29 weeks of gestation. Study design: This was a multicenter, retrospective cohort study of neonates (n = 12 515) born at 236/7 weeks of gestational age, admitted to neonatal intensive care units participating in the Canadian Neonatal Network who received prophylactic indomethacin started within the first 12 hours after birth. Univariate and multivariate analysis compared the composite outcomes of early death or severe neurologic injury and early death or spontaneous intestinal perforation. Results: Of 12 515 eligible neonates, 1435 (11.5%) were exposed to prophylactic indomethacin; recipients were of lower gestational age and birth weight and had greater severity of illness (Score of Neonatal Acute Physiology with Perinatal Extension) on admission compared with nonrecipients. After we adjusted for confounders, prophylactic indomethacin was associated with reduced odds of early death or severe neurologic injury and early death or spontaneous intestinal perforation in neonates born at 23-24 weeks of gestational age. However, prophylactic indomethacin was associated with increased odds of early mortality or spontaneous intestinal perforation for neonates born at 26-28 weeks of gestational age. Conclusions: Prophylactic indomethacin use was associated with benefit in neonates born at 23-24 weeks of gestational age, but with harm at 26-28 weeks of gestational age. Given the observation of significantly improved survival, a randomized controlled trial is needed to investigate the effect of prophylactic indomethacin in babies born at 23-25 weeks of gestational age.",
author = "Mosarrat Qureshi and Shah, {Prakesh S.} and Dalal Abdelgadir and Ye, {Xiang Y.} and Jehier Afifi and Ryan Yuen and Crossman, {Sara Calderon} and Barbara Taylor and Khorshid Mohammad and Bruno Piedboeuf and Khalid Aziz and Marc Beltempo and Jaideep Kanungo and Joseph Ting and Zenon Cieslak and Rebecca Sherlock and Mehrem, {Ayman Abou} and Jennifer Toye and Carlos Fajardo and Zarin Kalapesi and Jaya Bodani and Koravangattu Sankaran and Lannae Strueby and Mary Seshia and Deepak Louis and Ruben Alvaro and Amit Mukerji and {Da Silva}, Orlando and Mohammad Adie and Lee, {Kyong Soon} and Eugene Ng and Brigitte Lemyre and Faiza Khurshid and Ermelinda Pelausa and Keith Barrington and Anie Lapoint and Guillaume Ethier and Christine Drolet and Martine Claveau and Valerie Bertelle and Edith Masse and Roderick Canning and Hala Makary and Cecil Ojah and Luis Monterrosa and Julie Emberley and Andrzej Kajetanowicz and Lee, {Shoo K.}",
note = "Funding Information: Supported by the Canadian Neonatal Network was provided by the Maternal-infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by the Canadian Institutes of Health Research (CIHR) (CTP 87518), the Ontario Ministry of Health and Long-Term Care, and the participating hospitals. P.S. holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research from the CIHR (APR-126340). The funding agencies had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The authors declare no conflicts of interest. Funding Information: Supported by the Canadian Neonatal Network was provided by the Maternal-infant Care Research Centre ( MiCare ) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by the Canadian Institutes of Health Research (CIHR) (CTP 87518), the Ontario Ministry of Health and Long-Term Care, and the participating hospitals. P.S. holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research from the CIHR (APR-126340). The funding agencies had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",
year = "2021",
month = aug,
doi = "10.1016/j.jpeds.2021.02.073",
language = "English",
volume = "235",
pages = "26--33.e2",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
}
TY - JOUR
T1 - Gestational Age-Dependent Variations in Effects of Prophylactic Indomethacin on Brain Injury and Intestinal Injury
AU - Qureshi, Mosarrat
AU - Shah, Prakesh S.
AU - Abdelgadir, Dalal
AU - Ye, Xiang Y.
AU - Afifi, Jehier
AU - Yuen, Ryan
AU - Crossman, Sara Calderon
AU - Taylor, Barbara
AU - Mohammad, Khorshid
AU - Piedboeuf, Bruno
AU - Aziz, Khalid
AU - Beltempo, Marc
AU - Kanungo, Jaideep
AU - Ting, Joseph
AU - Cieslak, Zenon
AU - Sherlock, Rebecca
AU - Mehrem, Ayman Abou
AU - Toye, Jennifer
AU - Fajardo, Carlos
AU - Kalapesi, Zarin
AU - Bodani, Jaya
AU - Sankaran, Koravangattu
AU - Strueby, Lannae
AU - Seshia, Mary
AU - Louis, Deepak
AU - Alvaro, Ruben
AU - Mukerji, Amit
AU - Da Silva, Orlando
AU - Adie, Mohammad
AU - Lee, Kyong Soon
AU - Ng, Eugene
AU - Lemyre, Brigitte
AU - Khurshid, Faiza
AU - Pelausa, Ermelinda
AU - Barrington, Keith
AU - Lapoint, Anie
AU - Ethier, Guillaume
AU - Drolet, Christine
AU - Claveau, Martine
AU - Bertelle, Valerie
AU - Masse, Edith
AU - Canning, Roderick
AU - Makary, Hala
AU - Ojah, Cecil
AU - Monterrosa, Luis
AU - Emberley, Julie
AU - Kajetanowicz, Andrzej
AU - Lee, Shoo K.
N1 - Funding Information:
Supported by the Canadian Neonatal Network was provided by the Maternal-infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by the Canadian Institutes of Health Research (CIHR) (CTP 87518), the Ontario Ministry of Health and Long-Term Care, and the participating hospitals. P.S. holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research from the CIHR (APR-126340). The funding agencies had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The authors declare no conflicts of interest.
Funding Information:
Supported by the Canadian Neonatal Network was provided by the Maternal-infant Care Research Centre ( MiCare ) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by the Canadian Institutes of Health Research (CIHR) (CTP 87518), the Ontario Ministry of Health and Long-Term Care, and the participating hospitals. P.S. holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research from the CIHR (APR-126340). The funding agencies had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The authors declare no conflicts of interest.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/8
Y1 - 2021/8
N2 - Objective: To evaluate the impact of prophylactic indomethacin on early death (<10 days after birth) or severe neurologic injury and on early death or spontaneous intestinal perforation by completed weeks of gestational age in neonates born <29 weeks of gestation. Study design: This was a multicenter, retrospective cohort study of neonates (n = 12 515) born at 236/7 weeks of gestational age, admitted to neonatal intensive care units participating in the Canadian Neonatal Network who received prophylactic indomethacin started within the first 12 hours after birth. Univariate and multivariate analysis compared the composite outcomes of early death or severe neurologic injury and early death or spontaneous intestinal perforation. Results: Of 12 515 eligible neonates, 1435 (11.5%) were exposed to prophylactic indomethacin; recipients were of lower gestational age and birth weight and had greater severity of illness (Score of Neonatal Acute Physiology with Perinatal Extension) on admission compared with nonrecipients. After we adjusted for confounders, prophylactic indomethacin was associated with reduced odds of early death or severe neurologic injury and early death or spontaneous intestinal perforation in neonates born at 23-24 weeks of gestational age. However, prophylactic indomethacin was associated with increased odds of early mortality or spontaneous intestinal perforation for neonates born at 26-28 weeks of gestational age. Conclusions: Prophylactic indomethacin use was associated with benefit in neonates born at 23-24 weeks of gestational age, but with harm at 26-28 weeks of gestational age. Given the observation of significantly improved survival, a randomized controlled trial is needed to investigate the effect of prophylactic indomethacin in babies born at 23-25 weeks of gestational age.
AB - Objective: To evaluate the impact of prophylactic indomethacin on early death (<10 days after birth) or severe neurologic injury and on early death or spontaneous intestinal perforation by completed weeks of gestational age in neonates born <29 weeks of gestation. Study design: This was a multicenter, retrospective cohort study of neonates (n = 12 515) born at 236/7 weeks of gestational age, admitted to neonatal intensive care units participating in the Canadian Neonatal Network who received prophylactic indomethacin started within the first 12 hours after birth. Univariate and multivariate analysis compared the composite outcomes of early death or severe neurologic injury and early death or spontaneous intestinal perforation. Results: Of 12 515 eligible neonates, 1435 (11.5%) were exposed to prophylactic indomethacin; recipients were of lower gestational age and birth weight and had greater severity of illness (Score of Neonatal Acute Physiology with Perinatal Extension) on admission compared with nonrecipients. After we adjusted for confounders, prophylactic indomethacin was associated with reduced odds of early death or severe neurologic injury and early death or spontaneous intestinal perforation in neonates born at 23-24 weeks of gestational age. However, prophylactic indomethacin was associated with increased odds of early mortality or spontaneous intestinal perforation for neonates born at 26-28 weeks of gestational age. Conclusions: Prophylactic indomethacin use was associated with benefit in neonates born at 23-24 weeks of gestational age, but with harm at 26-28 weeks of gestational age. Given the observation of significantly improved survival, a randomized controlled trial is needed to investigate the effect of prophylactic indomethacin in babies born at 23-25 weeks of gestational age.
UR - http://www.scopus.com/inward/record.url?scp=85106296462&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85106296462&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2021.02.073
DO - 10.1016/j.jpeds.2021.02.073
M3 - Article
C2 - 33689709
AN - SCOPUS:85106296462
SN - 0022-3476
VL - 235
SP - 26-33.e2
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -