Prophylactic Aspirin Therapy for the Prevention of Patent Ductus Arteriosus in Very Low Birth Weight Infants

Lee, Young Ah

Abstract

PURPOSE: To evaluate the effectiveness of prophylactic intravenous aspirin and its effects on the mortality and morbidity associated with patent ductus arteriosus and intraventricular hemorrhage in very low birth weight infants with respiratory distress syndrome.
METHODS
Thirty-three premature newborn infants with birth weight less than 1,500 gram who were admitted to the neonatal intensive care unit at Dong-A university hospital from March 2000 to March 2001, were included in this study. They were randomly assigned to receive either aspirin lysine, 10 mg/kg per dose, or saline between 12 and 24 hour of age and again every 6 hours for total 4 doses. Primary outcome was the presence of ductus arteriosus by echocardiography performed between 3 and 5 days of life. Secondary outcome variables included the presence of intraventricular hemorrhage and bronchopulmonary dysplasia, the duration of ventilator care and oxygen therapy, and the mortality rate. Side effects or complications such as oliguria, elevated serum creatinine concentration, thrombocytopenia, pulmonary hemorrhage, and necrotizing enterocolitis were recorded.
RESULTS
Nineteen infants received normal saline (control group : birth weight, 1,189+/-203 gm; gestational age, 29.5+/-2.3 wk) and fourteen infants received aspirin lysine (aspirin group : birth weight, 1,162+/-199 gm; gestational age, 29.6+/-1.9 wk) (P>0.05). Eight of 19 infants in the control group (42.1%) and 1 of 14 infants in the aspirin group (7.1%) had patent ductus arteriosus (P<0.05). There were no significant differences between both groups in any of the secondary outcome variables or in the incidence of side effects.
CONCLUSION
The prophylactic use of aspirin decreased the incidence of patent ductus arteriosus, but had no effects on the incidence of intracranial hemorrhage, respiratory outcomes, and mortality. No significant side effects were found due to aspirin. Further studies are needed to determine the efficacy and safety of prophylactic aspirin therapy before its routine use can be recommended.