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

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dc.contributor.authorChawla, Sanjay
dc.contributor.authorNatarajan, Girija
dc.contributor.authorLaptook, Abbot R.
dc.contributor.authorChowdhury, Dhuly
dc.contributor.authorBell, Edward F.
dc.contributor.authorAmbalavanan, Namasivayam
dc.contributor.authorCarlo, Waldemar A.
dc.contributor.authorGantz, Marie
dc.contributor.authorDas, Abhik
dc.contributor.authorTapia, Jose L.
dc.contributor.authorHarmon, Heidi M.
dc.contributor.authorShankaran, Seetha
dc.date.accessioned2025-01-20T21:11:17Z
dc.date.available2025-01-20T21:11:17Z
dc.date.issued2022
dc.description.abstractBackground 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. Methods This retrospective cohort study included extreme preterm (22(0/7)-26(6/7) 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. Results 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. Conclusions 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. Impact 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.
dc.fuente.origenWOS
dc.identifier.doi10.1038/s41390-022-02012-z
dc.identifier.eissn1530-0447
dc.identifier.issn0031-3998
dc.identifier.urihttps://doi.org/10.1038/s41390-022-02012-z
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93618
dc.identifier.wosidWOS:000770230600001
dc.issue.numero6
dc.language.isoen
dc.pagina.final1656
dc.pagina.inicio1648
dc.revistaPediatric research
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleModel for severe intracranial hemorrhage and role of early indomethacin in extreme preterm infants
dc.typeartículo
dc.volumen92
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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