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

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 Re sponders (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.