Editorials

Treating extremely low birthweight infants with prophylactic indomethacin

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7329.60 (Published 12 January 2002) Cite this as: BMJ 2002;324:60

Evidence for short term benefits only

  1. William McGuire, senior lecturer in neonatal medicine (w.mcguire@dundee.ac.uk),
  2. Peter W Fowlie, honorary senior lecturer
  1. Tayside Institute of Child Health, Ninewells Hospital and Medical School, University of Dundee DD1 9SY

    A primary aim of perinatal and neonatal interventions for extremely low birthweight infants (birth weight less than 1000 g) is to increase the likelihood of survival without neurological disability.1 Although interventions, such as prophylactic antenatal steroids2 or exogenous surfactants,3 have improved certain outcomes, the overall prognosis for extremely low birthweight infants remains poor. In North America a multicentre cohort study of extremely low birthweight infants found that less than two thirds of those admitted to intensive care survived to hospital discharge. A quarter of surviving children, assessed at 18-22 months post term, had an abnormal neurological examination, and about a third had evidence of significant neurological developmental delay.4 In the United Kingdom and Eire, the EPICure Study Group evaluated the outcome for infants born before 26 weeks' gestation. The overall survival of infants admitted for intensive care was 39%.5 When assessed at a mean age of 30 months post term, about half the children had disability, and about half of …

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