title: Current Status of Therapeutic Strategies for Patent Ductus Arteriosus in Very-Low-Birth-Weight Infants in Korea.
abstract: This study aimed to investigate current therapeutic strategies for patent ductus arteriosus (PDA) in very-low-birth-weight (VLBW) infants in Korea. A total of 2,254 VLBW infants among 2,386 from Korean Neonatal Network cohort born from January 2013 to June 2014 were included. No PDA was seen for 1,206 infants (53.5%) and the infants diagnosed or treated for PDA were 1,048 infants (46.5%). The proportion of infants with PDA was decreased according to the increase in gestational age (GA) and birthweight. Infants with PDA were divided into groups according to the therapeutic strategies of PDA: prophylactic treatment (PT, n = 69, 3.1%), pre-symptomatic treatment (PST, n = 212, 9.4%), symptomatic treatment (ST, n = 596, 26.4%), and conservative treatment (CT, n = 171, 7.6%). ST was the most preferred treatment modality for preterm PDA and the proportion of the patients was decreased in the order of PST, CT, and PT. Although ST was still the most favored treatment in GA < 24 weeks group, CT was more preferred than PST or ST when compared with GA ≥ 32 weeks group [CT vs. PST, OR 5.3, 95% CI 1.56-18.18; CT vs. ST, OR 2.9, 95% CI 1.03-8.13]. A total of 877 infants (38.9%) received pharmacological or surgical treatment about PDA, and 35.5% (801 infants) received pharmacological treatment, mostly with ibuprofen. Seventy-six infants (3.4%) received primary ligation and 8.9% (201 infants) received secondary ligation. Diverse treatment strategies are currently used for preterm PDA in Korea. Further analyses of neonatal outcomes according to the treatment strategies are necessary to obtain a standardized treatment guideline for preterm PDA.
authors.affiliation: Department of Pediatrics, Seoul National University Boramae Hospital, Seoul, Korea. ; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jin A
authors.initials: JA
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Myo-Jing
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Biostatistics, Seoul National University Boramae Hospital, Seoul, Korea.
authors.forename: Sohee
authors.initials: S
authors.lastname: Oh
authors.affiliation: Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
authors.forename: Byung Min
authors.initials: BM
authors.lastname: Choi
mesh_terms: D015331:Cohort Studies; D016208:Databases, Factual; D004374:Ductus Arteriosus, Patent / Q000601:surgery / Q000628:therapy*; D004452:Echocardiography; D005865:Gestational Age; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D056910:Republic of Korea
chemical_list: D020097:Natriuretic Peptide, Brain; D007052:Ibuprofen
keywords: Korea; Patent Ductus Arteriosus; Treatment; Very-Low-Birth-Weight Infant