Prenatal exposure to indomethacin has been associated with which neonatal complication?

• A. NEC
• B. IUGR
• C. SVT
• D. Hypoglycemia

Answer: (A)

Indomethacin is an NSAID that crosses the placenta and inhibits prostaglandin synthesis. Prostaglandins keep the ductus arteriosus open and help maintain gut perfusion. When exposure happens before birth, the ductus arteriosus may close prematurely and mesenteric blood flow can decrease, increasing the risk of intestinal ischemia and necrotizing enterocolitis in the newborn, especially in preterm infants. This is why NEC is the neonatal complication most commonly associated with prenatal indomethacin exposure. Other potential problems exist with NSAID use, but they are not the classic neonatal complication linked to prenatal exposure in this context.