Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12887-021-02920-9
Title: Retrospective comparison of death or neurodevelopmental outcomes in extremely low birth weight preterm infants following different management options of haemodynamically significant patent ductus arteriosus
Authors: Wu, Jania Jia-Ying
Niduvaje, Krishnamoorthy 
Lee, Le Ye 
Amin, Zubair 
Keywords: Chronic lung disease
Conservative treatment
Death
Extremely preterm infants
Neurodevelopmental delay
Issue Date: 19-Oct-2021
Publisher: BioMed Central Ltd
Citation: Wu, Jania Jia-Ying, Niduvaje, Krishnamoorthy, Lee, Le Ye, Amin, Zubair (2021-10-19). Retrospective comparison of death or neurodevelopmental outcomes in extremely low birth weight preterm infants following different management options of haemodynamically significant patent ductus arteriosus. BMC Pediatrics 21 (1) : 457. ScholarBank@NUS Repository. https://doi.org/10.1186/s12887-021-02920-9
Rights: Attribution 4.0 International
Abstract: Background: Optimal management of haemodynamically significant patent ductus arteriosus (HsPDA) in premature babies remains controversial. Our aim is to compare death and/or adverse neurodevelopmental outcomes in extremely low birth weight (ELBW) infants with HsPDA who were managed with conservative [C], medical [M] and/or surgical [S] treatment, with secondary aim to examine short-term morbidities among [S] and [C] groups. The study also compared outcomes in very low birth weight (VLBW) infants with HsPDA and non-HsPDA. Methods: A retrospective study of VLBW preterm infants born before 29 weeks in Singapore from 2007 to 2016 was conducted. Results: A total of 474 VLBW infants were admitted in NUH from 2007 to 2016. Infants aged between 24 + 0 and 28 + 6 weeks of gestation, weighing ?1500 g and diagnosed with patent ductus arteriosus (PDA) were included in the study, of which 172 infants (124 HsPDA and 48 non-HsPDA) were analyzed. Among infants with HsPDA, 17 infants were managed with [C], 83 with [M] and 24 with [S]. Mortality was not increased regardless of the presence of HsPDA or treatment received. Infants with non-HsPDA were less likely to have isolated speech delay (p < 0.05), but not global developmental delay (GDD). No significant differences in neurodevelopmental outcomes such as hearing loss, cerebral palsy (CP) and speech delay were found. [M + S] infants were at a higher risk of developing chronic lung disease (CLD) (OR 6.83, p < 0.05) and short-term growth failure compared to [C] infants. They were significantly shorter and had a smaller head circumference at discharge (p < 0.05). [M + S] infants also had elevated creatinine compared to those in group [C] (81.1 ± 24.1 vs 48.3 ± 11.8 umol/L, p < 0.000). Conclusions: Compared to conservative management, infants requiring [M + S] treatment for HsPDA were more likely to have short-term complications such as CLD, elevated creatinine, and poorer growth. Despite a more turbulent postnatal course, death and/or adverse neurodevelopmental outcomes were not worse in infants managed with [M + S]. © 2021, The Author(s).
Source Title: BMC Pediatrics
URI: https://scholarbank.nus.edu.sg/handle/10635/232292
ISSN: 1471-2431
DOI: 10.1186/s12887-021-02920-9
Rights: Attribution 4.0 International
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