Neurosensory impairment after surgical closure of patent ductus arteriosus in extremely low birth weight infants: results from the Trial of Indomethacin Prophylaxis in Preterms

J Pediatr. 2007 Mar;150(3):229-34, 234.e1. doi: 10.1016/j.jpeds.2006.11.039.

Abstract

Objectives: To determine whether surgical closure of a patent ductus arteriosus (PDA) is a risk factor for bronchopulmonary dysplasia (BPD), severe retinopathy of prematurity (ROP), and neurosensory impairment in extremely low birth weight (ELBW) infants.

Study design: We studied 426 infants with a symptomatic PDA, 110 of whom underwent PDA ligation and 316 of whom received medical therapy only. All infants participated in the multicenter Trial of Indomethacin Prophylaxis in Preterms (TIPP) and were observed to a corrected age of 18 months.

Results: Of the 95 infants who survived after PDA ligation, 50 (53%) had neurosensory impairment, compared with 84 of the 245 infants (34%) who survived after receiving only medical therapy (adjusted odds ratio, 1.98; 95% CI, 1.18-3.30; P = .0093). BPD (adjusted odds ratio, 1.81; 95% CI, 1.09-3.03; P = .023) and severe ROP (adjusted odds ratio, 2.20; 95% CI, 1.19-4.07; P = .012) were also more common after surgical PDA closure.

Conclusions: PDA ligation may be associated with increased risks of BPD, severe ROP, and neurosensory impairment in ELBW infants.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cognition Disorders / etiology*
  • Cognition Disorders / prevention & control
  • Ductus Arteriosus, Patent / diagnostic imaging
  • Ductus Arteriosus, Patent / drug therapy*
  • Ductus Arteriosus, Patent / surgery*
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Humans
  • Indomethacin / therapeutic use*
  • Infant, Extremely Low Birth Weight
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Ligation / adverse effects
  • Male
  • Odds Ratio
  • Postoperative Complications / epidemiology
  • Primary Prevention / methods
  • Probability
  • Prospective Studies
  • Risk Assessment
  • Sensation Disorders / etiology*
  • Sensation Disorders / prevention & control
  • Treatment Outcome

Substances

  • Indomethacin