Patent ductus arteriosus ligation on neurodevelopmental outcomes at corrected 2\u2009years

Youngah Youn,Yu-Mi Seo,Sook-Kyung Yum,In Kyung Sung

doi:10.1186/s13052-019-0698-7

Youngah Youn, Yu-Mi Seo + Show 2 more

Open Access

https://doi.org/10.1186/s13052-019-0698-7

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Abstract

BackgroundOur aim in this study was to evaluate whether very low birth weight infants (VLBWI) ligated for patent ductus arteriosus (PDA) were associated with worse neurodevelopmental outcomes at corrected 2 years. The ligated group was subdivided into ≤2 weeks of life (early) and ligated > 2 weeks of life (late) groups and compared the in-hospital morbidities and long term outcomes.MethodsBetween Dec 2013 and Dec 2015, VLBWI diagnosed with hs PDA were evaluated.ResultsOf the 191 VLBW infants with hs PDA, 28 (14.7%) infants had surgical ligation for PDA; 11 (39%) infants had EL and 17 (61%) infants had LL. Surgical ligation of hs PDA group had higher morbidities and mortality. Among the142 (83.0%) infants of 171 VLBWI with PDA survived, infants who were ligated had significantly lower scores of Bayley Scales of Infant and Toddler Development III at corrected age of 18 months. However, among the ligated group, there was little evidence of differences between the EL and LL groups. In a multivariable logistic regression analysis, only longer exposure of hs PDA and mechanical ventilation were consistently associated with worse neurodevelopmental outcomes.ConclusionOur results suggest that surgical ligation for hs PDA may not increase risk for poor neurodevelopmental outcomes at corrected 2 years of age. The early surgical ligation may not be a risk factor.

Highlights

Patent ductus arteriosus (PDA) is one of the most frequently faced morbidities which accounts 70% of preterm infants born before 28 weeks’ gestation [1]
Longer exposure of hs patent ductus arteriosus (PDA) and mechanical ventilation were consistently associated with worse neurodevelopmental outcomes
Among the very low birth weight infants (VLBWI) with PDA, the mean gestational age and birth weight were significantly lower in the PDA ligated group compared to non-ligated group (27.2 ± 12.7 vs 28.7 ± 17.8, 1003 ± 186 vs 1070 ± 285, p = 0.001), pulmonary hypertension ≤1 week of life, oral ibuprofen use, exposure to hs PDA and neonatal seizures were significantly more prevalent in the ligated group (p < 0.05)

Summary

Introduction

Patent ductus arteriosus (PDA) is one of the most frequently faced morbidities which accounts 70% of preterm infants born before 28 weeks’ gestation [1]. McNamara and Sehgal criteria [3] of PDA to infants in our neonatal intensive care unit (NICU) beginning in 2012 This criterion is based on echocardiographic findings in combination with clinical findings and is staged from mild to severe Our target for treatment of hs PDA included infants with at least moderate-stage HSDA (stage C3) based on the criteria developed by McNamara and Sehgal [3]. Our aim in this study was to evaluate whether VLBWI ligated were associated with worse neurodevelopmental outcome at corrected 18 months in addition to hospital morbidities and mortality. Our aim in this study was to evaluate whether very low birth weight infants (VLBWI) ligated for patent ductus arteriosus (PDA) were associated with worse neurodevelopmental outcomes at corrected 2 years. The ligated group was subdivided into ≤2 weeks of life (early) and ligated > 2 weeks of life (late) groups and compared the in-hospital morbidities and long term outcomes

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Discussion

Conclusion