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Am J Perinatol 2021; 38(05): 449-455
DOI: 10.1055/s-0039-1697674
Original Article

Neurodevelopmental Impairment at Two Years in Premature Infants with Prolonged Patency of Ductus Arteriosus after a Conservative Approach

Victoria Aldecoa-Bilbao 
1   Department of Neonatology, Hospital Clínic Barcelona, ICGON, BCNatal, Universitat de Barcelona, Barcelona, Spain
,
Maria-Jesús García-Catalán
2   Department of Pediatrics, Hospital Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
,
Marta Gaixa
3   Department of Pediatric, Centre Desenvolupament Infantil i Atenció Precoç, Hospital Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
,
Jordi Clotet Caba
1   Department of Neonatology, Hospital Clínic Barcelona, ICGON, BCNatal, Universitat de Barcelona, Barcelona, Spain
,
Silvia Teodoro
4   Department of Pediatric Cardiology, Hospital Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
,
Carme Figaró Voltà
5   Department of Neonatology, Hospital Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
› Author Affiliations Funding This study was funded by Institut Investigació Innovació Parc Taulí Sabadell I3PT (Grant/Award number: “CIR2015/058”).
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Abstract

Objective The study aims to assess the impact on neurodevelopmental outcomes of a prolonged hemodynamically significant patent ductus arteriosus (PDA) after a conservative treatment.

Study Design This involves the study of two cohorts of preterm infants 23 to 29 weeks gestation, before (n = 29) and after (n = 54) a conservative approach of PDA. We compared survival, major outcomes, and neurodevelopmental impairment (NDI) at 2 years and analyzed NDI in the conservative cohort according to the duration of the PDA.

Results Conservative cohort received less medical (31.5%) and surgical treatment (7.4%) and had more days of PDA (59 days in 24–26 weeks and 22 days in 27–29 weeks; p < 0.001) in comparison with control cohort (19 days in 24–26 weeks and 11 days in 27–29 weeks; p = 0.688). Mortality, survival-without-morbidity at discharge, and NDI at 2 years were similar between the two groups (p = 0.732). In the multivariate analysis PDA >28 days was not related to worse outcomes at discharge (p = 0.296) or less survival-without-NDI at 2 years (p = 0.498).

Conclusion Until randomized trials prove the benefit of attempting to close the PDA with ibuprofen in the first week of life, conservative management may be a reasonable option.

Keywords

conservative management - neurodevelopmental impairment - patent ductus arteriosus - preterm infant


Publication History

Received: 02 February 2019

Accepted: 23 August 2019

Article published online:
10 October 2019

© 2019. Thieme. All rights reserved.

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