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Antecedents of Cerebral Palsy in a Multicenter Trial of Indomethacin for Intraventricular Hemorrhage-Reply

Walter C. Allan, MD; Betty Vohr, MD; Robert W. Makuch, PhD; Karol H. Katz, MS; Laura R. Ment, MD
Arch Pediatr Adolesc Med. 1997;151(12):1270. doi:10.1001/archpedi.1997.02170490095024.
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We appreciate the critical review by Dr Blair and we too regret that we have not identified a definitive relationship between indomethacin prophylaxis and CP. We have reported all the meaningful data we have collected and the results only suggest indomethacin therapy reduces the rate of CP. Our original hypothesis was that indomethacin by preventing IVH, and particularly grade 3 to 4 hemorrhage, might improve outcome in these infants. As we clearly indicate in Tables 3 and 4, indomethacin therapy did dramatically reduce all significant cranial USAs (grade 3-4IVH, ventriculomegaly, and cystic periventricular leukomalacia) from 14% in the saline-treated group to 6% (P<.01). However, as given in Table 4 and mentioned in the text, it did not significantly lower the incidence of CP. As Dr Blair points out, there was a 27% lowering of the incidence of CP in the group exposed to indomethacin therapy. This suggests a trend


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