Symptoms of vocal cord paresis among children born extremely premature with- or without PDA ligation. A Norwegian national cohort study.

Abstract

Background: Treatment of patent ductus arteriosus (PDA) in extremely preterm (EP) born infants is debated. If active measures are decided, two options are available; cyclooxygenase inhibitors or surgical ligation. The latter option is associated with verified but varying rates of left vocal cord paralysis (LVCP), causing respiratory problems often confused with other disorders such as asthma. It is unknown if LVCP leads to recognizable patterns of respiratory symptoms. Objective: To identify respiratory symptoms in EP-born children exposed to surgical ligation of PDA. Methods: This was a sub-study of all infants with a significant PDA (n=163) enrolled in a nationwide questionnaire based study of all children born EP during 1999-2000 at gestational age Results: Surgical ligation had been performed in 51/163 infants with PDA, leaving 112 unligated as control group. There were 91 responders, 35 ligated and 56 unligated controls. Scraping sounds during physical exercise were reported by respectively 23% vs. 7% (p=0.031), hoarseness by 23% vs. 2% (p Conclusion: Children born EP with a neonatal history of surgically ligated PDA had more respiratory symptoms and used more asthma medication than comparable EP born children with a PDA that had not been surgically treated. As LVCP may pass undiagnosed in neonates, symptoms may easily be confused with asthma in later life. These children should undergo laryngoscopy.