Spontaneous Closure of the Patent Ductus Arteriosus in Very Low Birth Weight Infants Following Discharge from the Neonatal Unit

Kristy Herrman ¹, Carl Bose ², Kristi Lewis ² and Matthew Laughon ^2*

¹ Pediatrix Medical Group, Austin, TX, United States
² The University of North Carolina at Chapel Hill, United States

^* To whom correspondence should be addressed. E-mail: matt_laughon{at}med.unc.edu.

Accepted 20 March 2008

Abstract

Objective:To determine the incidence of spontaneous closure of the patent ductus arteriosus (PDA) and the use of medical therapies for treatment of PDA-related conditions among very low birth weight (VLBW) infants with ductal patency at the time of initial hospital discharge.

Study Design: We conducted a single center, retrospective, observational study of VLBW infants (birth weight <1500 grams) born during 2004 and 2005 and were discharged with a PDA. PDA was defined by echocardiographic and/or clinical criteria. We identified the related discharge needs, subsequent interventions, and the post-menstrual age (PMA) at which there was no longer evidence of a PDA.

Results: 391 VLBW infants were admitted; 310 survived to discharge. 95 were diagnosed with a PDA during their hospitalizations; 21 had a PDA at discharge (10 received indomethacin, 11 were never treated). Among these, mean gestational age was 28 weeks, mean birth weight was 998 gm, and median duration of hospitalization was 73 days. 2 infants were discharged on oxygen, 2 on diuretics, and 2 on both. None had congestive heart failure, and none died during infancy. Spontaneous closure occurred in 18 of 21 infants at a median PMA of 48 weeks (range 34-76; IQR 46-56). 2 infants had coil occlusion at a PMA of 11 months. 1 patient had a PDA at a PMA of 14 months.

Conclusions: Among a select group of VLBW infants with a PDA at initial hospital discharge, spontaneous closure during early infancy occurred in most infants.