Oral ibuprofen promoted cholestatic liver disease in very low birth weight infants with patent ductus arteriosus

Summary Objectives Hemodynamically significant patent ductus arteriosus (hsPDA) in very low birth weight (VLBW) infants is routinely treated in many countries with oral ibuprofen. This study retrospectively assessed whether the risk of cholestatic liver disease (CLD) increased due to oral ibuprofen administration in VLBW infants. Methods A total of 122 VLBW preterm infants (26∼32 weeks, birth weight  Results The duration of PN increased due to ibuprofen treatment for 6.559 days (95% CI: 1.769, 11.349; P = 0.008), and the risk of prolonged fasting (cutoff > 5 days) might have increased due to ibuprofen treatment (OR: 3.043, 95% CI: 0.965, 9.594; P = 0.057). Furthermore, CLD was influenced by ibuprofen treatment (OR: 6.730; 95% CI: 1.279, 35.41; P = 0.024), early thrombocytopenia 7 days postnatal (OR: 6.996; 95% CI: 1.769, 27.658; P = 0.004), and late onset sepsis (OR: 6.976; 95% CI: 1.561, 31.169; P = 0.011). Further analysis adjusting for cholestasis-associated risk factors revealed that CLD was influenced by the duration of ibuprofen treatment (OR: 2.864; 95% CI: 1.104, 7.422; P = 0.030), Platlets counts 7 days postnatal (OR: 0.971; 95% CI: 0.950, 0.994; P = 0.013), and duration of antibiotics (OR: 1.134; 95% CI: 1.002, 1.282; P = 0.046). Conclusions This retrospective study indicated oral ibuprofen duration-dependently increased the risk of CLD in VLBW infants with PDA, and early thrombocytopenia served as the critical risk factor.