Routine Indomethacin Prophylaxis: Has the Time Come?

Periventricular-intraventricular hemorrhage (IVH) remains a significant cause of long-term morbidity among premature infants1. Clinical trials2-4 have shown that prophylactic indomethacin is associated with a decreased incidence of IVH, including the severe form. In this issue of Pediatrics, Ment et al5 report on the long-term outcome of children who received indomethacin prophylaxis for IVH. Incidence of cerebral palsy (8%) was similar between the indomethacin-and placebo-treated groups; mean IQ scores determined from the Stanford-Binet Intelligence Scale (Form L-M, 1972) did not differ. IQ scores were significantly related to IVH, birth weight, and maternal education; ie, lower IQ scores with IVH and higher scores with higher birth weight and years of education.