Korean J Perinatol.  2013 Sep;24(3):158-167. 10.14734/kjp.2013.24.3.158.

Association with Ductus Arteriosus Closure by Ibuprofen and Intrauterine Inflammation in Very Low Birth Weight Infants

• Seon HS
• Lee JB
• Kim IU
• Kim SH
• Lee JH
• Kim DH
• Kim HS

• KMID: 2280938
• DOI: http://doi.org/10.14734/kjp.2013.24.3.158

Abstract

PURPOSE
Ibuprofen is an inhibitor of prostaglandin synthesis and used to close a patent ductus arteriosus (PDA) of preterm infants. This study investigated the association between the response to ibuprofen treatment for PDA and maternal intrauterine inflammation in preterm infants.
METHODS
We retrospectively reviewed the medical records of very low birth weight (VLBW) infants diagnosed with PDA, who are admitted immediately after birth in the neonatal intensive care unit at Dongguk University Ilsan Hospital between March 2010 and May 2013. After the first cycle of ibuprofen therapy, infants whose ductus arteriosus was closed and not closed were classified as Responders and Non-responders I, respectively. After the second cycle of ibuprofen therapy, infants with persistent PDA were classified as Non-responders II. We performed multiple logistic regression analysis to determine the most important factor associated with persistent PDA.
RESULTS
After the first cycle of ibuprofen therapy, the numbers of Responders and Non-responders I were 40 and 14, respectively. Rate of cesarean section was significantly lower in Non-responders I than that of Responders (P=0.023). In addition, Rate of maternal amnionitis in Non-responder I was significantly higher than that of Responders (P=0.016). By multiple logistic regression analysis, maternal amnionitis was found to be a significant risk factor of the failure of ductus arteriosus closure after the first cycle of ibuprofen treatment (P=0.039).
CONCLUSION
The present study shows that maternal amnionitis is an independent risk factor for the treatment failure after the first cycle of ibuprofen therapy in VLBW infants with PDA.

Keyword

Patent ductus arteriosus; Intrauterine inflammation; Amnionitis; Very low birth weight infant

MeSH Terms

Amnion
Cesarean Section
Chorioamnionitis
Ductus Arteriosus*
Ductus Arteriosus, Patent
Female
Humans
Ibuprofen*
Infant*
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight*
Inflammation*
Intensive Care, Neonatal
Logistic Models
Medical Records
Parturition
Pregnancy
Retrospective Studies
Risk Factors
Treatment Failure
Ibuprofen

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