A Matched Case Control Study of Surgically and Non-surgically Treated Patent Ductus Arteriosus in Extremely Pre-term Infants

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Olsson, Karl Wilhelm,1985-Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning (author)

A Matched Case Control Study of Surgically and Non-surgically Treated Patent Ductus Arteriosus in Extremely Pre-term Infants

Article/chapterEnglish2021

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2021-03-18
Frontiers Media S.A.2021
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LIBRIS-ID:oai:DiVA.org:uu-441165
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-441165URI
https://doi.org/10.3389/fped.2021.648372DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Introduction: There are still uncertainties about the timing and indication for surgical ligation of patent ductus arteriosus (PDA) in pre-term infants, where lower gestational age (GA) usually is predictive for surgical treatment.Objective: Our aim was to assess differences in clinical characteristics and outcomes between surgically treated and matched non-surgically treated PDA in extremely pre-term infants.Methods: All extremely pre-term infants born 2010-2016 with surgically treated PDA (Ligated group; n = 44) were compared to non-surgically treated infants (Control group; n = 44) matched for gestational age (+/-1 week) and time of birth (+/-1 month). Perinatal parameters, echocardiographic variables, details of pharmacological PDA treatment, morbidity, and mortality were assessed.Result: Mean GA and birthweight were similar between the Ligated group (24(+5) +/- 1(+3) weeks and 668 +/- 170 g) and the Control group (24(+5) +/- 1(+3) weeks and 704 +/- 166 g; p = 1.000 and p = 0.319, respectively). Infants in the Ligated group had larger ductal diameters prior to pharmacological treatment, and lack of diameter decrease and PDA closure after treatment (p = 0.022, p = 0.043 and 0.006, respectively). Transfusions, post-natal steroids and invasive respiratory support were more common in the Ligated group. Except for a higher incidence of severe bronchopulmonary dysplasia (BPD) in the Ligated group there were no other differences in outcomes or mortality between the groups.Conclusion: Early large ductal diameter and reduced responsiveness to pharmacological treatment predicted the need for future surgical ligation in this matched cohort study of extremely pre-term infants where the effect of GA and differences in treatment strategies were excluded. Besides an increased incidence of severe BPD in the Ligated group, no other differences in morbidity or mortality were detected.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Pediatrik hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Pediatrics hsv//eng
case-control study
echocardiography
extreme pre-maturity
ligation
patent ductus arteriosus

Added entries (persons, corporate bodies, meetings, titles ...)

Youssef, SawinUppsala universitet,Institutionen för kvinnors och barns hälsa (author)
Kjellberg, MattiasUppsala universitet,Perinatal, neonatal och barnkardiologisk forskning(Swepub:uu)matkj573 (author)
Raaijmakers, RenskeSahlgrens Univ Hosp, Dept Pediat, Div Neonatol, Gothenburg, Sweden. (author)
Sindelar, Richard,Docent,1964-Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning(Swepub:uu)richsind (author)
Uppsala universitetPerinatal, neonatal och barnkardiologisk forskning (creator_code:org_t)

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In:Frontiers in Pediatrics: Frontiers Media S.A.92296-2360

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