Effects of prophylactic indomethacin on intraventricular hemorrhage and adverse outcomes in neonatal intensive care unit

Objective To identify the relationship between prophylactic indomethacin (PI) administration and incidence of intraventricular hemorrhage. Study design A retrospective analysis of extremely premature infants <27 weeks gestational age born between January 2014 and September 2020. Results A total of 421 infants were included from three of Nationwide Children’s Hospital delivery centers. Of those 255 (61%) received PI. After adjustment by inverse proportionality treatment weighting (IPTW), no differences were found in incidence of intraventricular hemorrhage (IVH) at the time of the first ultrasound, 31% vs. 33% in PI and control groups respectively ( p = 0.68). The rate of rise of serum creatinine from baseline to day of life four was significantly higher in the PI group (0.14 mg/dl PI and 0.03 mg/dl control, p < 0.001). Conclusion PI was not associated with any benefit in prevention of IVH, but is associated with adverse effects including acute rise in creatinine.