title: The timing of surgical ligation for patent ductus arteriosus is associated with neonatal morbidity in extremely preterm infants born at 23-25 weeks of gestation.
abstract: The purpose of this study was to evaluate prognostic factors associated with surgical ligation for patent ductus arteriosus (PDA) in extremely preterm infants born at the limits of viability. Ninety infants who were born at 23-25 weeks of gestation and who received surgical ligation were included and their cases were retrospectively reviewed. Infants were classified into two different groups: survivors with no major morbidity (N), and non-survivors or survivors with any major morbidity (M). Clinical characteristics were compared between the groups. Possible prognostic factors were derived from this comparison and further tested by logistic regression analysis. The mean gestational age and the mean birth weight of M were significantly lower than those of N. Notably, the mean postnatal age at time of ligation in N was significantly later than that of the other group (17 ± 12 vs 11 ± 8 days in N and M, respectively). An adjusted analysis showed that delayed ligation (>2 weeks) was uniquely associated with a significantly decreased risk for mortality or composite morbidity after surgical ligation (OR, 0.105; 95% CI, 0.012-0.928). In conclusion, delayed surgical ligation for PDA (>2 weeks) is associated with decreased mortality or morbidities in extremely preterm infants born at 23-25 weeks of gestation.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Se In
authors.identifier: 0000-0002-8717-6142
authors.initials: SI
authors.lastname: Sung
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Soo Young
authors.identifier: 0000-0001-5541-4479
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Jae Hyun
authors.identifier: 0000-0001-8953-3695
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Myung Sook
authors.identifier: 0000-0002-2148-7394
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Hye Soo
authors.identifier: 0000-0001-7230-1839
authors.initials: HS
authors.lastname: Yoo
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: So Yoon
authors.identifier: 0000-0002-1821-3173
authors.initials: SY
authors.lastname: Ahn
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Yun Sil
authors.identifier: 0000-0001-9201-2938
authors.initials: YS
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Won Soon
authors.identifier: 0000-0002-8245-4692
authors.initials: WS
authors.lastname: Park
mesh_terms: D000328:Adult; D001724:Birth Weight; D003710:Demography; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
keywords: Ductus Arteriosus, Patent; Ibuprofen; Indomethacin; Ligation
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