Morbidities associated with patent ductus arteriosus in preterm infants. Nationwide cohort study
- 11 July 2017
- journal article
- research article
- Published by Informa UK Limited in The Journal of Maternal-Fetal & Neonatal Medicine
- Vol. 31 (19), 2576-2583
- https://doi.org/10.1080/14767058.2017.1347921
Abstract
Purpose: To evaluate the predictive factors for the development of haemodynamically significant patent ductus arteriosus (PDA) in preterm infants and to study the morbidities associated with the treatment of PDA during the first hospitalization. Materials and methods: Data were collected from the Finnish national register of preterm infants (n = 1132) and infants who received no treatment for PDA (n = 2536). The results were adjusted for the duration of pregnancy, intrauterine growth pattern, antenatal steroids, delivery hospital and respiratory distress syndrome (RDS). Results: RDS and mechanical ventilation were independently associated with an increased risk of PDA requiring treatment. Medical and surgical treatments were associated with the risk of severe bronchopulmonary dysplasia (BPD). Primary surgical ligation was associated with an increased risk of severe intraventricular haemorrhage (IVH) and necrotizing enterocolitis (NEC). Medical treatment itself and also followed by surgical ligation was associated with lower mortality. Conclusion: The severity of lung disease rather than prematurity per se was associated with the development of PDA requiring therapy. Both medical and surgical therapies for PDA were associated with severe BPD, and primary surgical ligation was associated with NEC and severe IVH.Keywords
Funding Information
- Lastentautien Tutkimussäätiö (1)
- Medical Research Centre Oulu, Finland (1)
- Sigrid Juséliuksen Säätiö (1)
- Stiftelsen Alma och K. A. Snellman Säätiö (1)
This publication has 31 references indexed in Scilit:
- Chemokine CCL18 predicts intraventricular hemorrhage in very preterm infantsAnnals of Medicine, 2010
- Early Surgical Ligation Versus a Conservative Approach for Management of Patent Ductus Arteriosus That Fails to Close after Indomethacin TreatmentThe Journal of Pediatrics, 2010
- Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?Journal of Perinatology, 2010
- The Role of Patent Ductus Arteriosus Ligation in Bronchopulmonary Dysplasia: Reexamining a Randomized Controlled TrialThe Journal of Pediatrics, 2009
- Patent Ductus Arteriosus Therapy: Impact on Neonatal and 18-Month OutcomePediatrics, 2009
- Indomethacin prophylaxis, patent ductus arteriosus, and the risk of bronchopulmonary dysplasia: Further analyses from the Trial of Indomethacin Prophylaxis in Preterms (TIPP)The Journal of Pediatrics, 2006
- Impact of a Physiologic Definition on Bronchopulmonary Dysplasia RatesPediatrics, 2004
- A blinded comparison of clinical and echocardiographic evaluation of the preterm infant for patent ductus arteriosusJournal of Paediatrics and Child Health, 1994
- Incidence and evolution of subependymal and intraventricular hemorrhage: A study of infants with birth weights less than 1,500 gmThe Journal of Pediatrics, 1978
- Neonatal Necrotizing EnterocolitisAnnals of Surgery, 1978