Low Rate of Spontaneous Closure in Premature Infants Discharged with a Patent Ductus Arteriosus: A Multicenter Prospective Study
| Autor: | M. Whit Walker, Michael Hinkes, Anthony C. Rudine, Kaashif A. Ahmad, Amy S. Kelleher, Ray Y. Sato, Basharat Buchh, Reese H. Clark, Kenneth M. Shaffer, Meiyun Ma, Matthew C. Egalka, Moira Richards, George C. Powers, Kristy K. Herrman, Veeral N. Tolia |
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| Rok vydání: | 2021 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty Birth weight Population Ductus arteriosus Occlusion medicine Humans Prospective Studies Adverse effect education Prospective cohort study Ductus Arteriosus Patent education.field_of_study business.industry Incidence (epidemiology) Infant Newborn Gestational age Infant Infant Low Birth Weight Patient Discharge Surgery medicine.anatomical_structure Pediatrics Perinatology and Child Health business Infant Premature |
| Zdroj: | The Journal of pediatrics. 240 |
| ISSN: | 1097-6833 0275-0228 |
| Popis: | Objectives To assess the rate of spontaneous closure and the incidence of adverse events in infants discharged home with a patent ductus arteriosus. Study design In a prospective multicenter study, we enrolled 201 premature infants (gestational age of 23-32 weeks at birth) discharged home with a persistently patent ductus arteriosus (PDA) and followed their PDA status at 6-month intervals through 18 months of age. The primary study outcome was the rate and timing of spontaneous ductal closure. Secondary outcomes included rate of assisted closure and the incidence of serious adverse events. Results Spontaneous ductal closure occurred in 95 infants (47%) at 12 months and 117 infants (58%) by 18 months. Seventeen infants (8.4%) received assisted closure with surgical ligation or device assisted occlusion. Three infants died (1.5%). Although infants with spontaneous closure had a higher mean birth weight and gestational age compared with infants with a persistent PDA or assisted closure, we did not identify other factors predictive of spontaneous closure. Conclusions Spontaneous closure of the PDA occurred in slightly less than one-half of premature infants discharged with a patent ductus by 1 year, lower than prior published reports. The high rate of assisted closure and/or adverse events in this population warrants close surveillance following discharge. Trial registration ClinicalTrials.gov: NCT02750228 . |
| Databáze: | OpenAIRE |
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