Results of a multicenter randomized trial of low-dose indomethacin (0.1 mg/kg IV) in prevention of intraventricular hemorrhage (IVH) in very low birth weight infants are reported from Yale New Haven Hospital, CT; Brown University, Providence, RI; and Maine Medical Center, Portland, ME. The incidence and severity of IVH were significantly lowered. Of 431 neonates enrolled, 25 (12%) treated and 40 (18%) controls developed IVH. Grade 4 IVH occurred in only 1 indomethacin-treated neonate and in 10 placebo-treated controls. [1]

COMMENT. Volpe JJ, Harvard Medical School, and Reynolds EOR and Meek J, University College, London, are concerned about the cerebral vasoconstrictor effects of indomethacin and the dangers of periventricular ischemic injury [2]. These authorities are reluctant to endorse wholesale treatment of low birth weight newborns with indomethacin.