Evaluation of the association between patent ductus arteriosus approach and neurodevelopment in extremely preterm infants

Author:

Altit Gabriel1ORCID,Soledad Belén2,Saeed Sahar,Gorgos Andreea3,Beltempo Marc4ORCID,Basso Olga,Luu Thuy Mai,Lapointe Anie,Tremblay Sophie

Affiliation:

1. Montreal Children's Hospital

2. CHU Ste-Justine

3. Montreal Children's Hospital, McGill University

4. Montreal Children's Hospital, McGill University Health Centre

Abstract

Abstract Objective Assess if unit-level PDA management correlates with neurodevelopmental impairment (NDI) at 18–24 months corrected gestational age (cGA) in extremely preterm infants. Study design: Retrospective analysis of infants born at < 29 weeks (2014–2017) across two units having distinct PDA strategies. Site 1 utilized an echocardiography-based treatment strategy aiming accelerated closure (control). Site 2 followed a conservative approach. Primary endpoint: NDI, characterized by cerebral palsy, any Bayley-III composite score < 85, sensorineural/mixed hearing loss, or at least unilateral visual impairment. Results 377 infants were evaluated. PDA treatment rates remained unchanged in Site 1 but eventually reached 0% in Site 2. Comparable rates of any/significant NDI were seen across both sites (any NDI: 38% vs 36%; significant NDI: 13% vs 10% for Site 1 and 2, respectively). After adjustments, NDI rates remained similar. Conclusion PDA management strategies in extremely preterm newborns showed no significant impact on neurodevelopment outcomes at 18–24 months cGA.

Publisher

Research Square Platform LLC

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