TY - JOUR AU - Mantle, Ashley; Yang, Michelle J.; Judkins, Allison; Chanthavong, Iwa; Yoder, Bradley A.; Chan, Belinda TI - Association of Intrapartum Drugs with Spontaneous Intestinal Perforation: A Single-Center Retrospective Review SN - 0735-1631 SN - 1098-8785 PY - 2021 JO - Am J Perinatol JF - American Journal of Perinatology LA - EN VL - 41 IS - 02 SP - 174 EP - 179 DA - 2021/11/28 ET - 2021/10/19 KW - extremely low birth weight KW - spontaneous intestinal perforation KW - indomethacin KW - hydrocortisone KW - betamethasone KW - magnesium KW - neonate AB - Objective Spontaneous intestinal perforation (SIP) occurs commonly in extremely low gestational age newborns (ELGANs; <30 weeks' GA). Early, concurrent neonatal use of indomethacin (Neo_IN) and hydrocortisone (Neo_HC) is a known risk for SIP. Mothers in premature labor often receive indomethacin (Mat_IN) for tocolysis and steroids (Mat_S) for fetal maturation. Coincidentally, ELGANs may receive Neo_IN or Neo_HC within the first week of life. There are limited data on the effect of combined exposures to maternal and neonatal medications. We hypothesized that proximity exposure to these medications may increase the risk of SIP.Study Design We reviewed the medical records of ELGANs from June 2014 to December 2019 at a single level III neonatal intensive care unit. We compared antenatal and postnatal indomethacin and steroid use between neonates with and without SIP. For analysis, chi-square, Student's t-test, Fisher's exact test, and Mann–Whitney U tests were used.Results Among 417 ELGANs, SIP was diagnosed in 23, predominantly in neonates < 26 weeks' GA (n = 21/126, 16.7%). Risk factors analysis focused on this GA cohort in which SIP was most prevalent. Mat_IN administration within 2 days of delivery increased SIP risk (odds ratio: 3; 95% confidence interval: 1.25–7.94; p = 0.036). Neo_HC was not independently associated with SIP (p = 0.38). A higher proportion of SIP group had close temporal exposure of Mat_IN and Neo_HC compared with the non-SIP group, though not statistically significant (14 vs. 7%, p = 0.24).Conclusion Peripartum Mat_IN was associated with increased risk for SIP in this small study sample. Larger studies are needed to further delineate SIP risk from the interaction of peripartum maternal medication with early postnatal therapies and disease pathophysiology.Key Points PB - Thieme Medical Publishers, Inc. DO - 10.1055/a-1673-0183 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-1673-0183 ER -