BACKGROUND: Patent ductus arteriosus (PDA) is a condition frequently found in very preterm infants, and its treatment remains a subject of debate. Furthermore, there are only a few studies available that have examined the impact of these treatments on the neurological outcome of the patient. OBJECTIVE: To evaluate the neurodevelopmental outcome of PDA treatment on preterm infants born between 24+0 and 28+6 weeks of gestation. METHODS: We conducted an observational multicentric cohort study (LIFT Cohort). We compared three groups of patients according to their PDA treatment strategy: medical treatment with ibuprofen, surgical ligation, and no treatment. The neurodevelopmental outcome was assessed with a physical examination and cognitive function evaluation at 2 years of age. A propensity score was used to reduce bias in the analysis. RESULTS: Between 2003 and 2011, 857 infants (91.3%) were evaluated at 2 years of corrected age and included in the analysis: 248 received ibuprofen treatment (29%), 104 had PDA surgical ligation (12%), and 505 did not receive any PDA treatment (59%). Surgical ligation of PDA was significantly associated with neurodevelopmental impairment at 2 years of age (adjusted odds ratio = 2.2; 95% confidence interval: 1.4-3.4). CONCLUSION: We found an association between PDA surgical ligation and a nonoptimal neurodevelopmental outcome at 2 years of age for preterm infants born before 29 weeks of gestation. These results suggest that if surgical ligation is unavoidable, particular attention should be given to the patient's neurodevelopmental follow-up.
BACKGROUND: Patent ductus arteriosus (PDA) is a condition frequently found in very preterm infants, and its treatment remains a subject of debate. Furthermore, there are only a few studies available that have examined the impact of these treatments on the neurological outcome of the patient. OBJECTIVE: To evaluate the neurodevelopmental outcome of PDA treatment on preterm infants born between 24+0 and 28+6 weeks of gestation. METHODS: We conducted an observational multicentric cohort study (LIFT Cohort). We compared three groups of patients according to their PDA treatment strategy: medical treatment with ibuprofen, surgical ligation, and no treatment. The neurodevelopmental outcome was assessed with a physical examination and cognitive function evaluation at 2 years of age. A propensity score was used to reduce bias in the analysis. RESULTS: Between 2003 and 2011, 857 infants (91.3%) were evaluated at 2 years of corrected age and included in the analysis: 248 received ibuprofen treatment (29%), 104 had PDA surgical ligation (12%), and 505 did not receive any PDA treatment (59%). Surgical ligation of PDA was significantly associated with neurodevelopmental impairment at 2 years of age (adjusted odds ratio = 2.2; 95% confidence interval: 1.4-3.4). CONCLUSION: We found an association between PDA surgical ligation and a nonoptimal neurodevelopmental outcome at 2 years of age for preterm infants born before 29 weeks of gestation. These results suggest that if surgical ligation is unavoidable, particular attention should be given to the patient's neurodevelopmental follow-up.
Authors: Dany E Weisz; Lucia Mirea; Erin Rosenberg; Maximus Jang; Linh Ly; Paige T Church; Edmond Kelly; S Joseph Kim; Amish Jain; Patrick J McNamara; Prakesh S Shah Journal: JAMA Pediatr Date: 2017-05-01 Impact factor: 16.193
Authors: Madeleine L Barnett; Nora Tusor; Gareth Ball; Andrew Chew; Shona Falconer; Paul Aljabar; Jessica A Kimpton; Nigel Kennea; Mary Rutherford; A David Edwards; Serena J Counsell Journal: Neuroimage Clin Date: 2017-11-21 Impact factor: 4.881
Authors: Melinda Barkhuizen; Raul Abella; J S Hans Vles; Luc J I Zimmermann; Diego Gazzolo; Antonio W D Gavilanes Journal: Pediatr Cardiol Date: 2020-12-29 Impact factor: 1.655
Authors: Esther J S Jansen; Tim Hundscheid; Wes Onland; Elisabeth M W Kooi; Peter Andriessen; Willem P de Boode Journal: Front Pediatr Date: 2021-02-09 Impact factor: 3.418
Authors: Tim Hundscheid; Esther J S Jansen; Wes Onland; Elisabeth M W Kooi; Peter Andriessen; Willem P de Boode Journal: Front Pediatr Date: 2021-02-25 Impact factor: 3.418