Association of Co-Exposure of Antenatal Steroid and Prophylactic Indomethacin with Spontaneous Intestinal Perforation

This retrospective cohort study of 4,720 extremely preterm infants demonstrates that combined exposure to antenatal steroids and prophylactic indomethacin increases the risk of spontaneous intestinal perforation, particularly when steroids are administered within 7 days of birth. The findings suggest clinicians should carefully weigh timing of antenatal steroid administration when prophylactic indomethacin is planned for neuroprotection in this vulnerable population.