Neurodevelopmental Outcomes of Premature Infants Treated for Patent Ductus Arteriosus: A Population-Based Cohort Study

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• 作者：Estella M. Janz-Robinson ; BAppSc (BMedSc) ; MChD¹ ; Nadia Badawi ; MSc ; FRCPI ; FRACP ; PhD² ; ³ ; ⁴ ; Karen Walker ; RGN ; RSCN ; BAppSc ; MN ; PhD² ; ³ ; ⁴ ; Barbara Bajuk ; MPH⁵ ; Mohamed E. Abdel-Latif ; FRACP ; MRCPCH ; AFRACMA ; MPaeds ; MPH ; MScEpi ; MD⁶ ; ⁷ ; ^{Abdel-Latif.Mohamed@act.gov.au" class="auth_mail" title="E-mail the corresponding author} ; on behalf of the Neonatal Intensive Care Units Network^&lowast ; Dr. Jennifer Bowen (Chairperson) ; Barbara Bajuk (Coordinator) ; Sara Sedgley (Research Officer) ; Dr. Hazel Carlisle (Director) ; Judith Smith ; Dr. Paul Craven (Director) ; Dr. Rebecca Glover ; Lynne Cruden ; Alissa Argomand ; Dr. Ingrid Rieger (Director) ; Dr. Girvan Malcolm ; Tracey Lutz (Clinical Director) ; Shelley Reid ; Dr. Jacqueline Stack (Director) ; Dr. Ian Callander ; Kathryn Medlin ; Kaye Marcin ; Dr. Vijay Shingde ; Dr. Basiliki Lampropoulos ; Mee Fong Chin ; Kerrie Bonser ; Prof Nadia Badawi (Director) ; Dr. Robert Halliday ; Dr. Alison Loughran-Fowlds ; Caroline Karskens ; Dr. Mary Paradisis (Director) ; A/Prof Martin Kluckow ; Claire Jacobs ; Dr. Andrew Numa (Director) ; Dr. Gary Williams ; Janelle Young ; Dr. Melissa Luig (Director) ; Jane Baird ; A/Prof Kei Lui (Director) ; Dr. Lee Sutton ; Diane Cameron
• 关键词：BPD ; Bronchopulmonary dysplasia ; BSID-II-MDI ; Bayley Scales of Infant Development ; Second Edition ; Mental Development Index ; CLD ; Chronic lung disease ; CP ; Cerebral palsy ; ELBW ; Extremely low birth weight ; FD ; Functional disability ; GA ; Gestational age ; GMDS-GQ ; Griffiths Mental Development Scale ; General Quotient ; IVH ; Intraventricular hemorrhage ; NEC ; Necrotizing enterocolitis ; NICU ; Neonatal intensive care unit ; PDA ; Patent ductus arteriosus ; PDAMed ; Patent ductus arteriosus treated medically
• 刊名：The Journal of Pediatrics
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：167
• 期：5
• 页码：1025-1032.e3
• 全文大小：807 K

文摘

To compare neurodevelopmental outcomes of extremely preterm infants diagnosed with patent ductus arteriosus (PDA) who were treated medically or surgically and those who were not diagnosed with PDA or who did not undergo treatment for PDA.

Study design

This retrospective population-based cohort study used data from a geographically defined area in New South Wales and the Australian Capital Territory served by a network of 10 neonatal intensive care units. Patients included all preterm infants born at <29 completed weeks of gestation between 1998 and 2004. Moderate/severe functional disability at 2-3 years corrected age was defined as developmental delay, cerebral palsy requiring aids, sensorineural or conductive deafness (requiring bilateral hearing aids or cochlear implant), or bilateral blindness (best visual acuity of <6/60).

Results

Follow-up information at age 2-3 years was available for 1473 infants (74.8%). Compared with infants not diagnosed with a PDA or who did not receive PDA treatment for PDA, those with medically treated PDA (aOR, 1.622; 95% CI, 1.199-2.196) and those with surgically treated PDA (aOR, 2.001; 95% CI, 1.126-3.556) were at significantly greater risk for adverse neurodevelopmental outcomes at age 2-3 years.

Conclusion

Our results demonstrate that treatment for PDA may be associated with a greater risk of adverse neurodevelopmental outcome at age 2-3 years. This was particularly so among infants born at <25 weeks gestation. These results may support permissive tolerance of PDAs; however, reasons for this association remain to be elucidated through carefully designed prospective trials.