Patent Ductus Arteriosus in Premature Infants: to Treat or Not to Treat?

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2017 Feb 17

PMID 28206995

Citations 13

Authors

M A Mohamed

M El-Dib

S Alqahtani

K Alyami

A N Ibrahim

H Aly

Affiliations

Soon will be listed here.

Abstract

Objective: Closing patent ductus arteriosus (PDA) is a widely accepted approach in the management of very low birth weight (VLBW) infants. Our objective is to test the hypothesis that conservative management (no treatment) of PDA will not affect survival without chronic lung diseases (CLD).

Study Design: This retrospective study utilizes a prospectively collected database to compare two cohorts of VLBW infants. Infants in the first group (2001 to 2009) had their PDA treated with pharmacological and if necessary with surgical ligation. PDA in the second group (2010 to 2014) was not treated with medical or surgical intervention. The primary outcome was survival without oxygen requirement at 36 weeks. Pulmonary and non-pulmonary morbidities were also compared. Logistic regression analyses were performed to control for confounders.

Results: This study included 643 VLBW infants, of them 415 infants in the Treat group and 228 in the No-Treat group. The rate of survival without CLD did not differ between Treat and No-Treat groups (78.4% vs 83.9%, respectively; adjusted odds ratio (aOR)=1.72, confidence interval (CI): 0.92 to 3.23, P=0.09). Mortality declined in No-Treat group (15.2% vs 10.5%, aOR=0.51, CI: 0.25 to 0.99, P=0.049), but the two groups did not differ in the incidence of CLD among survivors (5.8% vs 5.0%,=P0.47). Pulmonary complications and non-pulmonary morbidities did not differ between groups.

Conclusions: Conservative management (no treatment) of PDA may not compromise survival without CLD and is not associated with increased morbidities in VLBW infants. Prospective physiological studies are needed to determine the sector of VLBW infants, if any, who could benefit from PDA treatment.

Citing Articles

Experience of patent ductus arteriosus ligation during extracorporeal membrane oxygenation treatment in newborns with severe respiratory failure due to persistent pulmonary hypertension: a single-center retrospective study.

Zhang Q, Liu Y, Zeng Y, Zheng Y, Chen Q Ital J Pediatr. 2024; 50(1):250.

PMID: 39578872 PMC: 11585135. DOI: 10.1186/s13052-024-01821-8.

Treatment of patent ductus arteriosus and short-term outcomes among extremely preterm infants: a multicentre cohort study.

Qian A, Jiang S, Gu X, Li S, Lei X, Shi W EClinicalMedicine. 2023; 67:102356.

PMID: 38125962 PMC: 10730999. DOI: 10.1016/j.eclinm.2023.102356.

[Interpretation of the key updates in the 2022 European guideline on the management of neonatal respiratory distress syndrome].

Lin M, Zhang X, Wang Y, Zhu X, Xue J Zhongguo Dang Dai Er Ke Za Zhi. 2023; 25(8):779-784.

PMID: 37668023 PMC: 10484088. DOI: 10.7499/j.issn.1008-8830.2303046.

Bronchopulmonary Dysplasia in Extremely Premature Infants: A Scoping Review for Identifying Risk Factors.

Ito M, Kato S, Saito M, Miyahara N, Arai H, Namba F Biomedicines. 2023; 11(2).

PMID: 36831089 PMC: 9953397. DOI: 10.3390/biomedicines11020553.

Effectiveness and safety of rectal dexibuprofen versus oral ibuprofen for closure of patent ductus arteriosus in preterm infants with gestational age<34 weeks: A pilot study.

Pan J, Yang Y, Cui S, Chen X, Zhou X Int J Immunopathol Pharmacol. 2023; 37:3946320231152993.

PMID: 36744872 PMC: 9905032. DOI: 10.1177/03946320231152993.

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