Long-term neurodevelopmental outcomes in very low birth weight infants with and without patent ductus arteriosus: A retrospective case control observational study.

Abstract

Patent ductus arteriosus (PDA) has been associated with early morbidities and long-term developmental problems in very preterm infants. The aim of this study is to investigate the effect of patent ductus arteriosus and medical treatment on long-term developmental outcomes in very low birth weight infants. This is a retrospective case control observational study. The study included preterm infants who were born before 30 weeks' gestation and birth weight less than 1,500 g and underwent neurodevelopmental testing at a corrected age of 24 months during follow-up in our centre. The results of neurodevelopmental assessment using the Bayley Scales of Infant Development II at 24 months of corrected age and other morbidities were recorded. Of 820 infants screened, the 2-year data of 647 infants (78%) were analysed. The mean gestational age was 27.4weeks (±1.7weeks), mean birth weight was 980 g (±250 g) and 283 (44%) of the infants received pharmaceutical treatment for hemodynamically significant PDA. The prevalence of neurodevelopmental impairment was higher in infants with PDA compared to those without PDA (odds ratio [OR], 1.6; 95% CI, 1.13-2.29; chi-square, Fisher's exact test P = .009). However, when birth weight and gestational age were corrected for as covariates and other risk factors were added to the analysis, PDA alone was not an independent risk factor for neurodevelopmental problems (OR, 1.12; 95% CI, 0.824-1.549; P = .450). There was no difference between the groups who received ibuprofen or paracetamol for PDA. Although we have not found an association between hemodynamically significant PDA and poor neurodevelopment, this potentially needs to be investigated.