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

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.