Efficacy of a first course of Ibuprofen for patent ductus arteriosus closure in extremely preterm newborns according to their gestational age-specific Z-score for birth weight.

Efficacy of a first course of Ibuprofen for patent ductus arteriosus closure in extremely preterm newborns according to their gestational age-specific Z-score for birth weight.

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OBJECTIVE:Therapeutic Car Mounts strategies for patent ductus arteriosus (PDA) in very preterm infants remain controversial.To identify infants likely to benefit from treatment, we analysed the efficacy of a first course of ibuprofen in small-for-gestational age (SGA) newborns.STUDY DESIGN:This single-centre retrospective study included 185 infants born at 24+0-27+6 weeks of gestation with haemodynamically significant PDA, who were treated by intravenous ibuprofen (Pedea): 10 mg/kg on day one and 5 mg/kg on days two and three.Birth weight and gestational age (GA) were analysed with reference to the standard deviations from the Olsen growth curve to define GA-specific Z-scores for birth weights.The efficacy of treatment was evaluated by echocardiography 48 hours after the last dose of ibuprofen.

The primary outcome was failure of the ORTHO-SLEEP first course of ibuprofen associated in a composite criterion with the most severe outcomes.RESULTS:The risk of treatment failure increased according to a continuous gradient in SGA neonates.A higher risk was observed on multiple regression analysis (crude OR: 3.8; 95% CI [1.2-12.

3] p = 0.02; adjusted OR: 12.8; 95% CI [2.3-70.5] p=0.

003).CONCLUSION:There is a linear relationship between infant birth weight and PDA treatment: the failure rate of a first course of ibuprofen increases with increasing degree of growth restriction.