78: Indomethacin Dose-Interruption & Maternal Chorioamnionitis as Risk Factors for Indomethacin Treatment Failure in Preterm Infants with PDA
Bibliographic record
Abstract
Preterm infants often respond differently to Indomethacin for PDA closure with some requiring multiple courses of the drug and subsequently surgical ligation. To identify perinatal and postnatal risk factors associated with failure of primary course of indomethacin for treatment of PDA. We studied infants who received indomethacin for PDA between 2010–2013. We identified those who failed primary pharmacotherapy and required subsequent courses or surgical ligation. Failure of primary course of indomethacin was defined as infants requiring more than one full course of indomethacin or received one full course of indomethacin followed by surgical ligation. Perinatal/neonatal variables in infants with and without indomethacin failure were compared by univariate analysis. Subsequently, variables which had significant difference two groups were selected to carry out logistic regression analysis. Out of 77 infants analyzed, 36 (46.7%) had primary indomethacin failure and nine infants (11.7%) underwent surgical ligation. Univariate analysis revealed that infants with primary indomethacin failure were significantly more immature, of male sex, did not receive a complete course of antenatal corticosteroids, indomethacin dose interruption was documented during clinical care and their mothers had clinical chorioamnionitis. (Table 1). The multivariable logistic regression analysis showed that dose interruption and clinical chorioamnionitis were independent risk factors for indomethacin failure (Table 2). Indomethacin dose interruption and clinical chorioamnionitis appear to be independent risk factors for primary indomethacin failure in preterm infants. This study generates an important and previously unexplored hypothesis regarding the role of dosage interruption in treatment failure. This could pave the way for future prospective cohort studies to better analyze this interaction and also prospective RCTs to potentially find a solution to this problem.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".