TY - JOUR
T1 - Does indomethacin prevent preterm birth in women with cervical dilatation in the second trimester?
AU - Berghella, Vincenzo
AU - Prasertcharoensuk, Witoon
AU - Cotter, Amanda
AU - Rasanen, Juha
AU - Mittal, Suneeta
AU - Chaithongwongwatthana, Surasith
AU - Gomez, Ricardo
AU - Kearney, Etaoin
AU - Tolosa, Jorge E.
AU - Pereira, Leonardo
PY - 2009/1
Y1 - 2009/1
N2 - We sought to estimate the effect of indomethacin on duration of pregnancy in women with dilated cervix between 14 0/7 to 25 6/7 weeks. Demographics, risk factors, and outcomes were compared in women 14 6/7 to 25 6/7 weeks with a dilated cervix ≥ 1 cm who received indomethacin versus no indomethacin therapy, stratified for cerclage. Primary outcome was interval from presentation until delivery. Of 222 singleton gestations, 68 (31%) received indomethacin. In unadjusted and adjusted analyses, no significant differences were observed in interval from presentation to delivery and preterm birth < 28, < 32, or < 35 weeks comparing the indomethacin and no indomethacin groups, even after stratification for cerclage. In multivariate logistic regression analysis limited to women receiving cerclage, preterm birth < 32 weeks (odds ratio 0.56, 95% confidence interval 0.26, 1.25) and < 35 weeks (odds ratio 0.52, 95% confidence interval 0.23, 1.14) suggested a possible but not significant benefit for indomethacin use. Indomethacin therapy in women with dilated cervix at 14 0/7 to 25 6/7 weeks, regardless of cerclage or not, had no effect on pregnancy outcomes.
AB - We sought to estimate the effect of indomethacin on duration of pregnancy in women with dilated cervix between 14 0/7 to 25 6/7 weeks. Demographics, risk factors, and outcomes were compared in women 14 6/7 to 25 6/7 weeks with a dilated cervix ≥ 1 cm who received indomethacin versus no indomethacin therapy, stratified for cerclage. Primary outcome was interval from presentation until delivery. Of 222 singleton gestations, 68 (31%) received indomethacin. In unadjusted and adjusted analyses, no significant differences were observed in interval from presentation to delivery and preterm birth < 28, < 32, or < 35 weeks comparing the indomethacin and no indomethacin groups, even after stratification for cerclage. In multivariate logistic regression analysis limited to women receiving cerclage, preterm birth < 32 weeks (odds ratio 0.56, 95% confidence interval 0.26, 1.25) and < 35 weeks (odds ratio 0.52, 95% confidence interval 0.23, 1.14) suggested a possible but not significant benefit for indomethacin use. Indomethacin therapy in women with dilated cervix at 14 0/7 to 25 6/7 weeks, regardless of cerclage or not, had no effect on pregnancy outcomes.
KW - Cerclage
KW - Cervical dilatation
KW - Indomethacin
KW - Preterm labor
UR - http://www.scopus.com/inward/record.url?scp=58349100508&partnerID=8YFLogxK
U2 - 10.1055/s-0028-1091398
DO - 10.1055/s-0028-1091398
M3 - Article
C2 - 19021101
AN - SCOPUS:58349100508
SN - 0735-1631
VL - 26
SP - 13
EP - 20
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 1
ER -