title: Neurodevelopmental Outcomes of Premature Infants Treated for Patent Ductus Arteriosus: A Population-Based Cohort Study.
abstract: OBJECTIVE
  To compare neurodevelopmental outcomes of extremely preterm infants diagnosed with patent ductus arteriosus (PDA) who were treated medically or surgically and those who were not diagnosed with PDA or who did not undergo treatment for PDA.
  
  
  METHODS
  This retrospective population-based cohort study used data from a geographically defined area in New South Wales and the Australian Capital Territory served by a network of 10 neonatal intensive care units. Patients included all preterm infants born at <29 completed weeks of gestation between 1998 and 2004. Moderate/severe functional disability at 2-3 years corrected age was defined as developmental delay, cerebral palsy requiring aids, sensorineural or conductive deafness (requiring bilateral hearing aids or cochlear implant), or bilateral blindness (best visual acuity of <6/60).
  
  
  RESULTS
  Follow-up information at age 2-3 years was available for 1473 infants (74.8%). Compared with infants not diagnosed with a PDA or who did not receive PDA treatment for PDA, those with medically treated PDA (aOR, 1.622; 95% CI, 1.199-2.196) and those with surgically treated PDA (aOR, 2.001; 95% CI, 1.126-3.556) were at significantly greater risk for adverse neurodevelopmental outcomes at age 2-3 years.
  
  
  CONCLUSIONS
  Our results demonstrate that treatment for PDA may be associated with a greater risk of adverse neurodevelopmental outcome at age 2-3 years. This was particularly so among infants born at <25 weeks gestation. These results may support permissive tolerance of PDAs; however, reasons for this association remain to be elucidated through carefully designed prospective trials.
authors.affiliation: Department of Medicine, Canberra Hospital, Garran, Australian Capital Territory, Australia.
authors.forename: Estella M
authors.initials: EM
authors.lastname: Janz-Robinson
authors.affiliation: Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, Australia; Cerebral Palsy Alliance Research Foundation, Notre Dame University, Sydney, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Nadia
authors.initials: N
authors.lastname: Badawi
authors.affiliation: Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, Australia; Cerebral Palsy Alliance Research Foundation, Notre Dame University, Sydney, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Walker
authors.affiliation: Neonatal Intensive Care Units Data Collection, NSW Pregnancy and Newborn Services Network, Sydney Children's Hospitals Network, Sydney, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bajuk
authors.affiliation: Department of Neonatology, Centenary Hospital for Women and Children, Garran, Australian Capital Territory, Australia; Medical School, College of Medicine, Biology & Environment, Australian National University, Acton, Canberra, Australia. Electronic address: Abdel-Latif.Mohamed@act.gov.au.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abdel-Latif
mesh_terms: D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000601:surgery* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008297:Male; D008423:Maternal Age; D009517:New South Wales; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome