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1265 What is Best for Persistent Patent Ductus Arteriosus Treatment: Ibuprofen or Indomethacin? Follow Up at 1 and 2 Years
  1. F Loeve1,
  2. D Vijlbrief1,2,
  3. C Blaauw3,
  4. RA van Lingen1
  1. 1Princess Amalia Department of Paediatrics, Department of Neonatology, Isala Clinics, Zwolle
  2. 2Department of Neonatology, Wilhelmina Childrens’ Hospital/UMCU, Utrecht
  3. 3Medical Psychology, Isala Clinics, Zwolle, The Netherlands

Abstract

Background and Aims Patent ductus arteriosus (PDA) is particularly a problem of extreme preterm infants. PDA is treated with either indomethacin or ibuprofen. Pulmonary symptoms at 2 yrs, developmental outcome at 1 and 2 yrs and difference in occurrence of bronchopulmonary dyplasia (BPD) between ibuprofen and indometacin, compared to matched controls without PDA were evaluated.

Design Historical cohort-study.

Methods Preterm infants <32 weeks GA were included. Neurodevelopmental outcome at 1 and 2 yrs corrected age was evaluated by means of cognitive and motor scales of the Bayley-II or the Bayley-III. The parents received a survey for pulmonary symptoms.

Results 89 children (26 ibu, 21 indo, 24 indocontrol and 18 ibucontrol) were included. Response to the survey was 82%. Groups did not differ in baseline characteristics. The cognitive and motor development did not differ between the groups at 1 yr. At 2 yrs cognitive scores are significantly better in the ibuprofengroup vs indomethacingroup (p=0.002). After correction of cognitive Bayley-II to Bayley-III scores, there are no differences between groups (p=0.709). Motor development is lower in the indomethacingroup than the indocontrolgroup (p=0.021) at 2 yrs. There were no differences in the incidence of BPD or pulmonary symptoms between the groups.

Conclusion Ibuprofen and indometacin have no influence on the pulmonary outcome and the occurrence of BPD. Indomethacin has a negative influence on motor development. Ibuprofen gives a better cognitive developmental outcome than indomethacin, but this may be an effect of using both the Bayley-II as the Bayley-III.

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