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


METHODS
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.
Kabra
Nandkishor S
NS
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Schmidt
Barbara
B
Roberts
Robin S
RS
Doyle
Lex W
LW
Papile
Luann
L
Fanaroff
Avroy
A
D003072:Cognition Disorders / Q000209:etiology* / Q000517:prevention & control; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008026:Ligation / Q000009:adverse effects; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D011322:Primary Prevention / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012678:Sensation Disorders / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome
D007213:Indomethacin