Neurodevelopmental outcome after COX inhibitor treatment for patent ductus arteriosus

Early Hum Dev. 2010 Feb;86(2):87-92. doi: 10.1016/j.earlhumdev.2009.12.009. Epub 2010 Feb 12.

Abstract

Aim: To compare neurodevelopmental results in very low birth weight (VLBW) infants two years after successful or failed cyclooxygenase inhibitor treatment with either indomethacin or ibuprofen for a haemodynamically significant patent ductus arteriosus (hsPDA).

Methods: We retrospectively evaluated closure rates and outcome parameters of VLBW infants with hsPDA 89 of whom were treated with indomethacin and 93 with ibuprofen.

Results: Indomethacin and ibuprofen therapy groups did not differ in their baseline clinical profile (median gestational age 26.0 and 26.2wksd) in early (median CRIB 6 and 5, respiratory distress >2 degrees in 36 and 34 infants) and late morbidities (intraventricular hemorrhage >2 degrees in 9 and 10 infants, bronchopulmonary dysplasia in 31 and 27 infants, 80 and 85 survivors), PDA closure rates (63 and 58%) or neurodevelopmental outcome. The therapy failure group (54 infants) was characterized by lower median gestational age (25.0wksd) and higher mortality (17%). No differences were found in the neurodevelopmental outcome of the surviving infants with ligation as compared to the survivors with successful pharmacological closure of the PDA at 24months corrected age.

Conclusion: Use of either ibuprofen or indomethacin for closure of a hsPDA did not influence two year neurodevelopmental outcomes in VLBW infants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Central Nervous System / drug effects*
  • Central Nervous System / growth & development
  • Child Development / drug effects
  • Child Development / physiology
  • Child, Preschool
  • Cyclooxygenase Inhibitors / therapeutic use*
  • Ductus Arteriosus, Patent / drug therapy*
  • Female
  • Gestational Age
  • Humans
  • Ibuprofen / therapeutic use*
  • Indomethacin / therapeutic use*
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Very Low Birth Weight
  • Male
  • Psychomotor Performance / drug effects
  • Psychomotor Performance / physiology
  • Retrospective Studies

Substances

  • Cyclooxygenase Inhibitors
  • Ibuprofen
  • Indomethacin