Developmental Sequelae in Premature Infants Undergoing Ligation of Patent Ductus Arteriosus

Abstract

One hundred sixteen infants who underwent on-unit ligation of patent ductus arteriosus (PDA) were examined for developmental sequelae. Mean gestational age of the study group was 29.1 weeks; mean birth weight, 1,232 gm; and mean duration of follow-up, 20.7 months (chronological age). Seven infants died of severe bronchopulmonary dysplasia (4) and severe central nervous system dysfunction (3) before they were 3 years old. Sixty-five percent of the remaining infants exhibited normal motor and mental development, although 58% showed some degree of postnatal growth retardation. There was no evidence of left arm dysfunction caused by the thoracic incision; 3 infants had minor problems with nonabsorbed sutures at 3 to 6 months of age. No infant demonstrated recurrence of ductal patency. Mild sensorineural handicaps not expected to be of long-term importance were noted in 20 infants. Eighteen other infants (15.5%) were classified as having moderate to severe impairments, which may have substantial impact on development and ability to function. Surgical ligation of PDA in premature infants has been shown to be safe and effective in the short run. Long-term follow-up suggests that infants who undergo PDA ligation do not appear to be at increased risk for sensorineural handicaps.