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

Autor: Aldecoa-Bilbao, Victoria, García-Catalán, Maria-Jesús, Gaixa, Marta, Clotet Caba, Jordi, Teodoro, Silvia, Figaró Voltà, Carme
Předmět:
Zdroj: American Journal of Perinatology; 2021, Vol. 38 Issue 5, p449-455, 7p
Abstrakt: 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index