ABSTRACT
BACKGROUND: Patent ductus arteriosus (PDA) is one of the more common congenital heart defects in preterm neonates. The closure of PDA can be done with ibuprofen; however, this drug is associated with many contraindications and potential side-effects. In the past years, paracetamol has been proposed for the treatment of PDA. This study was designed to evaluate the efficacy and gastrointestinal complications of paracetamol and ibuprofen for the pharmacological closure of PDA in preterm infants. METHODS: In a clinical trial study, 40 preterm infants with echocardiographically confirmed PDA were randomly assigned to receive either paracetamol (n = 23; 15 mg/kg every 6 h for 2 days) or ibuprofen (n = 17; initial dose of 10 mg/kg, followed by 5 mg/kg every 12 h for 2 days). The neonates matched for gestational age and weight. We used t-test for parametric, Chi-square for categorial, and Wilcoxson for nonparametric variables. Significant level was considered less than 0.05. RESULTS: Platelet count, BUN and creatinine levels, and closure of PDA had not significant difference between two groups (P > 0.05). Incidence and severity of GI bleeding, feeding intolerance, and NEC were significantly more in infants who received paracetamol than ibuprofen (P < 0.05). CONCLUSIONS: There were no differences in the rate of PDA closure between the two drugs, but with respect to complications, rate and severity of GI bleeding, feeding intolerance, and NEC were significantly more in infants who received paracetamol than ibuprofen. Therefore, paracetamol could not be used as a proper alternative agent for ibuprofen in the treatment of PDA in preterm infants.
ABSTRACT
BACKGROUND: Many very-preterm infants have difficulty in oral feeding during the first months of life after discharge. Since studies surveying the presence of feeding problems after the first year of life are limited and cultural/psychosocial differences can affect results, so the aim of this study was to compare scores of a feeding problems test between very-preterm and full-term born children at the age of 2 and study the relationship between obtained scores and explanatory variables. MATERIALS AND METHODS: This is a retrospective descriptive-analytic study conducted in 2014 in Semnan city of Iran. Thirty-eight 2-year-old children with the history of very-preterm birth were selected by census sampling method and 38 full-term babies born in the same hospital were selected randomly. The Iranian version of Lewinhson Feeding Disorders questionnaire was used and the relationship between explanatory variables and the total score of the questionnaire was surveyed in each group by Mann-Whitney and linear regression tests. RESULTS: Mean (SD) gestational age and weight of birth were 30.47 (1.63) weeks and 1630 (310) grams respectively in the very-preterm group. Feeding scores were not significantly higher in very-preterm babies, neither in total score (p > 0.05) nor in subtests. A relationship was just found between total feeding score and female gender both in the exposed group (ß = -0.36, p = 0.01) and non-exposed group (ß = -0.49, p = 0.002). CONCLUSIONS: Two-year-old children born very preterm did not have higher feeding problems scores than full-term born peers. Male gender was related to more feeding problems at 2 years of age.
