Neonatal Med.  2020 Aug;27(3):111-117. 10.5385/nm.2020.27.3.111.

Differences in Outcomes According to the Time of Patent Ductus Arteriosus Closure in Preterm Infants

• Han C
• Jeon GW

• KMID: 2505661
• DOI: http://doi.org/10.5385/nm.2020.27.3.111

Abstract

Purpose
Patent ductus arteriosus (PDA) is associated with increased mortality and morbidities such as intraventricular hemorrhage, necrotizing enterocolitis, bronch opulmonary dysplasia, and neurodevelopmental impairment. The objective of this study was to evaluate mortality and morbidities according to the time of PDA closure.
Methods
For this study, 117 preterm infants with gestational age (GA) of <30 weeks who had PDA were enrolled and allocated to two groups according to the time of PDA closure as follows: early closed group (n=40, PDA closure in <14 days after birth) and delayed closed group (n=77, PDA closure in ≥14 days after birth).
Results
GA was higher in the early closed group than in the delayed closed group (27.2±1.6 weeks vs. 26.3±1.7 weeks, P=0.005). Other demographic factors, such as birth weight, Apgar score, and maternal status were not significantly different between the two groups. The incidence rates of surfactant redosing, retinopathy of prematurity (stage ≥II), necrotizing enterocolitis (stage ≥II), moderate to severe bronchopulmo nary dysplasia, and mortality were similar between the two groups. The total durations of mechanical ventilation, invasive ventilation, and hospital stay were longer in the delayed closed group than in the early closed group. However, these became similar after adjustment for GA. The incidence rate of intraventricular hemorrhage (grade ≥III) was significantly higher in the early closed group than in the delayed closed group after adjustment for GA (25.0% vs. 13.0%, adjusted P for GA=0.021).
Conclusion
In this study, delayed PDA closure was safe, as it did not increase mortality and morbidity rates.

Keyword

Ductus arteriosus; patent; Infant; premature; Retinopathy of prematurity; Enterocolitis; necrotizing; Bronchopulmonary dysplasia

Figure

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  Figure 1. Patient flowchart. Abbreviations: GA, gestational age; PDA, Patent ductus arteriosus; HS, hemodynamically significant.

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