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OBJECTIVE: Indomethacin prophylaxis (IP) reduces the risk of intraventricular haemorrhage (IVH) and patent ductus arteriosus (PDA) in preterm infants. However, the optimal time to administer IP has not been determined. We hypothesised that IP at 6-24 h of age. METHODS: We performed a retrospective cohort study of extremely low birth weight infants (6-24 h of age. The primary outcomes were IVH alone and IVH or death. Secondary outcomes were PDA alone and PDA or death. We used multivariable analyses to determine associations between the age of IP and the study outcomes expressed as an OR and 95% CI. RESULTS: IP was given at 6-24 h to 1915 infants. Infants given IP at 6-24 h (OR 0.83, 95% CI 0.71 to 0.98). CONCLUSIONS: IP at