Spontaneous closure of the patent ductus arteriosus in very low birth weight infants following discharge from the neonatal unit.
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.


METHODS
We conducted a single-centre, retrospective, observational study of VLBW infants (birth weight <1500 g) born during 2004 and 2005 and 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
Three hundred and ninety one VLBW infants were admitted; 310 survived to discharge. Ninety five were diagnosed with a PDA during their hospitalisations; 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 g, and median duration of hospitalisation was 73 days. Two infants were discharged on oxygen, two on diuretics, and two 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; interquartile range 46-56). Two infants had coil occlusion at 11 months of age. One patient had a PDA at 14 months of age.


CONCLUSIONS
Among a select group of VLBW infants with a PDA at initial hospital discharge, spontaneous closure during early infancy occurred in most infants.
Herrman
K
K
Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Bose
C
C
Lewis
K
K
Laughon
M
M
D006328:Cardiac Catheterization / Q000379:methods; D002317:Cardiovascular Agents / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000628:therapy*; D004562:Electrocardiography; D004812:Epidemiologic Methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D019102:Infant, Very Low Birth Weight; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D011247:Pregnancy; D012075:Remission, Spontaneous; D016896:Treatment Outcome; D014463:Ultrasonography
D002317:Cardiovascular Agents; D007213:Indomethacin