Prophylactic Ibuprofen for the Prevention of Intraventricular Hemorrhage Among Preterm Infants: A Multicenter, Randomized Study

Dani, Carlo; Bertini, Giovanna; Pezzati, Marco; Poggi, Chiara; Guerrini, Piero; Martano, C; Rubaltelli, Firmino F.

doi:10.1542/peds.2004-1178

Cited by 81 publications

(66 citation statements)

References 51 publications

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“…A reduction in cerebral palsy in one small (27 subjects) trial of indomethacin prophylaxis 95 was not confirmed in two larger studies. 100,106 No trial showed beneficial impacts on pulmonary hemorrhage, 96,99,102,103,106 severe pulmonary hemorrhage, 110 PVL, 83,84,86 -89,95,96,100,101,103,107 any ROP 62,64,72 -74,76,84,85,89,90,95,96,105,106 or ROPXstage 2 84 or stage 3, 89,96,111 Bailey mental developmental index 79,96,106 or psychomotor developmental index, 79,96 mean Wechsler Preschool and Primary Scale of Intelligence, revised scores, 112 severe developmental delay, 96,100,106 or neurosensory impairment or neurosensory impairment or death. 96,103,106 In summary, individual randomized-controlled trials provide scant evidence of benefit from prophylaxis or treatment of PDA in preterm infants.…”

Section: Findings From Individual Randomized-controlled Trialsmentioning

confidence: 99%

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

2010

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Section: Findings From Individual Randomized-controlled Trialsmentioning

confidence: 99%

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

2010

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“…[7] The other seven of the abstracted 16 studies included very low birth weight (VLBW, ≤1500 g) preterm neonates. [3611182021] Five of them were conducted after widespread of antenatal steroid and surfactant era. [615172021] Table 1 depicts a summary of LBW studies and Table 2 depicts a summary of VLBW studies.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…[356710111213141516171819202122] Figures 1 and 2 depict the percentage of IVH cases in each report that occurred during these 4 time intervals in LBW and VLBW, respectively. These plots show that timing of IVH is bimodal in both LBW and VLBW neonates.…”

Section: Timing Of Ivh Occurrencementioning

confidence: 99%

“…[45678] A large body of evidence has shown that a considerable number of IVH cases occur during the first hours of life (HOL). [35679101112131415161718192021222324] Reports in the literature from the 1980s and 1990s established that IVH occurring within the first HOL and later-occurring IVH must be analyzed separately as their antecedents may be different. [252627] However, a more recent large and growing body of literature has considered early and late IVH as a single entity and has neglected the fact that a significant number of IVH cases may have occurred prior to the investigator's study intervention or antecedents of IVH.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review and meta-analysis of the timing of early intraventricular hemorrhage in preterm neonates: Clinical and research implications

Al-Abdi

Al-Aamri

2014

J Clin Neonatol

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A considerable number of intraventricular hemorrhages (IVH) occur within the first hours of life (HOL). Temporality between IVH and its antecedents as well as a consistent definition of “early IVH” is lacking in a large and growing body of literature. We performed a systematic review of prospective studies that reported onset of IVH in preterm neonates within the first HOL and afterwards. The English literature was searched using three databases up to March 2013. Four timing periods of IVH can be compared in 16 identified studies: 0-6; 7-12; 13-24; after 24 HOL. The 0-6 and after 24 HOL were the major modes of IVH timing. Pooled IVH proportions were estimated through a meta-analysis of studies that were conducted after antenatal steroid and surfactant era. In neonates weighing ≤1500 g at birth: 48% of IVH (95% CI: 42-58%, 5 studies, 279 IVH cases) occurred during 0-6 HOL and 38% (95% CI: 19-57%, 4 studies, 241 IVH cases) after 24 HOL. The 0-6 HOL is the shortest, most vulnerable period for IVH, thus, an early IVH is an IVH occurs in it. Such early IVH had prognostic, etiological/preventive and medicolegal implications. Accordingly, preterm neonates at risk of IVH should have their first routine screening head ultrasound at about 6 HOL. Future research exploring the antecedents of IVH should guaranty the temporality between these antecedents and IVH. Additional research will be required to determine whether the long term neurological outcomes of early and late IVH are the same.

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“…Currently, the use of indomethacin as a preventive strategy for IVH is not clearly recommended, although a prospective analysis of factors influencing white-matter abnormalities on MRI scans in extremely low GA infants has revealed a significant beneficial effect of indomethacin [29]. Unlike indomethacin, however, ibuprofen did not show any effect on the occurrence of IVH [30,31]. …”

Section: Modulators Of Inflammation/infectionmentioning

confidence: 99%

Impact of Common Treatments Given in the Perinatal Period on the Developing Brain

et al. 2014

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Background: Over the last decades, considerable progress has been made in the perinatal management of high-risk preterm neonates, changing the landscape of pathological conditions associated with neurological impairments. Major focal destructive lesions are now less common, and the predominant neuropathological lesion is diffuse white-matter damage in the most immature infants. Similarly, over the last few years, we have observed a trend towards a decrease in neurological impairment in the absence of treatments specifically aimed at neuroprotection. Objectives: We examined whether recent changes in treatment strategies in perinatal care during the perinatal period could have had an indirect beneficial impact on the occurrence of brain lesions and their consequences. Methods: Thus, we reviewed the effects of the most common treatments administered during the perinatal period to the mother or to very preterm infants on brain damage and neurocognitive follow-up. Results: Antenatal steroids and exogenous surfactant are the two main treatments capable of leading to neuroprotection in very preterm infants. Randomized controlled trials are currently investigating the effects of inhaled nitric oxide and erythropoietin, while antenatal magnesium sulphate and caffeine are also likely to provide some neuroprotection, but this needs to be further investigated. Finally, other common treatments against pain, haemodynamic failure and patent ductus arteriosus have conflicting or no effects on the developing brain. Conclusion: While specific neuroprotective drugs are still awaited, recent advances in perinatal care have been associated with an unexpected but significant decrease in the incidence of both severe brain lesions and neurological impairment.

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Prophylactic Ibuprofen for the Prevention of Intraventricular Hemorrhage Among Preterm Infants: A Multicenter, Randomized Study

Abstract: Our study demonstrated that prophylactic ibuprofen is ineffective in preventing grade 2 to 4 IVH and that its use for this indication cannot be recommended.

Cited by 81 publications

References 51 publications

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

A systematic review and meta-analysis of the timing of early intraventricular hemorrhage in preterm neonates: Clinical and research implications

Impact of Common Treatments Given in the Perinatal Period on the Developing Brain

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